Healthcare Provider Details

I. General information

NPI: 1538253380
Provider Name (Legal Business Name): LUIS ORLANDO CATALA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 CALLE PRINCIPAL LA VEGA
BARRANQUITAS PR
00794-1631
US

IV. Provider business mailing address

HC 3 BOX 8086 BO CANABON
BARRANQUITAS PR
00794-9501
US

V. Phone/Fax

Practice location:
  • Phone: 787-857-1775
  • Fax:
Mailing address:
  • Phone: 787-857-0775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number2815
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: