Healthcare Provider Details

I. General information

NPI: 1376759779
Provider Name (Legal Business Name): TRATAMIENTO NEUROLOGICO Y NEUMOLOGICO DEL SUENO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 CALLE GAUTIER BENITEZ
ARECIBO PR
00612-4418
US

IV. Provider business mailing address

PO BOX 846
ARECIBO PR
00613-0846
US

V. Phone/Fax

Practice location:
  • Phone: 787-816-0315
  • Fax: 787-880-1011
Mailing address:
  • Phone: 787-816-0315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number9371
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number6372
License Number StatePR

VIII. Authorized Official

Name: MRS. MARGARITA PEREZ
Title or Position: SECRETARY
Credential:
Phone: 787-816-0315