Healthcare Provider Details

I. General information

NPI: 1821558636
Provider Name (Legal Business Name): EBATEC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 03/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 GAUTIE BENITEZ CAGUAS
CAGUAS PR
00726
US

IV. Provider business mailing address

1018 AVE ASHFORD APTO 11 ASTOR
SAN JUAN PR
00907
US

V. Phone/Fax

Practice location:
  • Phone: 787-367-3974
  • Fax:
Mailing address:
  • Phone: 787-367-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. JAVIER DAVID SR.
Title or Position: PRESIDENT
Credential:
Phone: 787-367-3974