Healthcare Provider Details

I. General information

NPI: 1780907592
Provider Name (Legal Business Name): NAVARRO MEDICAL CENTER C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 03/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 CALLE DEGETAU N
AIBONITO PR
00705-3613
US

IV. Provider business mailing address

PO BOX 1705
AIBONITO PR
00705-1705
US

V. Phone/Fax

Practice location:
  • Phone: 787-954-0606
  • Fax: 787-954-0607
Mailing address:
  • Phone: 787-954-0606
  • Fax: 787-954-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number014653
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number014653
License Number StatePR

VIII. Authorized Official

Name: DR. NESTOR M UNGER
Title or Position: PRESIDENT
Credential:
Phone: 787-649-2020