Healthcare Provider Details

I. General information

NPI: 1780623108
Provider Name (Legal Business Name): NH ROTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 819 BOX 18
FPO AE
09645-0018
US

IV. Provider business mailing address

USNH ROTA SPAIN PSC 819 BOX 18
FPO AE
09645
US

V. Phone/Fax

Practice location:
  • Phone: 34956823515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MARCO GRANADO CABALLERO
Title or Position: UBO MANAGER
Credential:
Phone: 11-349-5682