Healthcare Provider Details

I. General information

NPI: 1376830398
Provider Name (Legal Business Name): EMP OF PUERTO RICO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2011
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 S DOUGLAS RD THIRD FLOOR
CORAL GABLES FL
33134-6925
US

IV. Provider business mailing address

2850 S DOUGLAS RD THIRD FLOOR
CORAL GABLES FL
33134-6925
US

V. Phone/Fax

Practice location:
  • Phone: 305-460-0939
  • Fax: 305-441-6632
Mailing address:
  • Phone: 305-460-0939
  • Fax: 305-441-6632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. OSVALDO DE LA PEDRAJA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 305-441-5939