Healthcare Provider Details
I. General information
NPI: 1184827370
Provider Name (Legal Business Name): DEPARTAMENTO DE SALUD OFICIAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2007
Last Update Date: 07/11/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CALLE DR. DEFENDINI # 4
ADJUNTAS PR
00601
US
IV. Provider business mailing address
CALLE DR. DEFENDINI # 4
ADJUNTAS PR
00601
US
V. Phone/Fax
- Phone: 787-829-2860
- Fax:
- Phone: 787-829-2860
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0002X |
| Taxonomy | Emergency Care Clinic/Center |
| License Number | |
| License Number State | PR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 09912 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 2 | |
| Identifier | 660433481 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 3 | |
| Identifier | S586 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 4 | |
| Identifier | SH00401 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 5 | |
| Identifier | 40148 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 6 | |
| Identifier | 600271 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 7 | |
| Identifier | 1000012 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 8 | |
| Identifier | 6604363425A |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 9 | |
| Identifier | 030724 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 10 | |
| Identifier | 19075 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 11 | |
| Identifier | 6010028 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 12 | |
| Identifier | 660433481A |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
| # 13 | |
| Identifier | 00384 |
| Identifier Type | OTHER |
| Identifier State | PR |
| Identifier Issuer | E R |
VIII. Authorized Official
Name:
YESAREL
PESANTE SANCHEZ
Title or Position: SECRETARIO AUXILIAR II
Credential:
Phone: 787-765-2929
