Healthcare Provider Details

I. General information

NPI: 1891063616
Provider Name (Legal Business Name): ACO DEL NORTE PPN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2011
Last Update Date: 12/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 16 V-1 URB. VILLA LOS SANTOS
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 9920 COTTO STATION
ARECIBO PR
00613-9920
US

V. Phone/Fax

Practice location:
  • Phone: 787-817-3144
  • Fax: 787-879-4315
Mailing address:
  • Phone: 787-817-3144
  • Fax: 787-879-4315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. JULIO A TORRES
Title or Position: DIRECTOR EJECUTIVO
Credential: LCDO.
Phone: 787-817-3144