Healthcare Provider Details

I. General information

NPI: 1851605547
Provider Name (Legal Business Name): NAVAL HOSPITAL ROTA SPAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2010
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 819 BOX 18 - 211
FPO AE
09645-9998
US

IV. Provider business mailing address

PSC 807 BOX 33
FPO AE
09729-0002
US

V. Phone/Fax

Practice location:
  • Phone: 6391039973681
  • Fax:
Mailing address:
  • Phone: 351913451230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID S LESSER SR.
Title or Position: FAMILY PRACTICIONER
Credential: M.D
Phone: 6691264303534