Healthcare Provider Details

I. General information

NPI: 1609958446
Provider Name (Legal Business Name): SOCIEDAD DE SERVICIOS NEONATALES DE ARECIBO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date: 07/17/2007
Reactivation Date: 09/19/2007

III. Provider practice location address

AVENIDA SAN LUIS CARR 129 KM1
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 141418
ARECIBO PR
00614
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-7272
  • Fax: 787-878-7272
Mailing address:
  • Phone: 787-880-6263
  • Fax: 787-880-6263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JINEAM RODRIGUEZ
Title or Position: ASISTAND ADMINISTRATOR
Credential:
Phone: 787-880-6263