Healthcare Provider Details

I. General information

NPI: 1821021213
Provider Name (Legal Business Name): EQUIPO GINECOLOGICO Y OBSTETRICO DE SALUD,P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 AVE DEGETAU APT 500 HIMA PLAZA I SUITE 505
CAGUAS PR
00725-5844
US

IV. Provider business mailing address

158 CALLE FONT MARTELO
HUMACAO PR
00791-3337
US

V. Phone/Fax

Practice location:
  • Phone: 787-744-5414
  • Fax: 787-258-4587
Mailing address:
  • Phone: 787-852-3560
  • Fax: 787-852-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MANUEL A NAVAS MICHEO
Title or Position: PRESIDENT
Credential: M.D., F.A.C.O.G.
Phone: 787-744-5414