Provider Demographics
NPI:1144630559
Name:EFG MEDICAL SERVICES,PSC
Entity type:Organization
Organization Name:EFG MEDICAL SERVICES,PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-763-0654
Mailing Address - Street 1:735 AVE PONCE DE LEON STE 618
Mailing Address - Street 2:
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00917-5029
Mailing Address - Country:US
Mailing Address - Phone:787-763-0654
Mailing Address - Fax:787-764-3476
Practice Address - Street 1:735 AVE PONCE DE LEON STE 618
Practice Address - Street 2:
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00917-5029
Practice Address - Country:US
Practice Address - Phone:787-763-0654
Practice Address - Fax:787-764-3476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89042Medicare UPIN