Healthcare Provider Details

I. General information

NPI: 1104977230
Provider Name (Legal Business Name): CENTRO DE NEUMOLOGIA PEDIATRICA CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LUIS MUNOZ MARIN
CAGUAS PR
00725-6184
US

IV. Provider business mailing address

PO BOX 8129
CAGUAS PR
00726-8129
US

V. Phone/Fax

Practice location:
  • Phone: 787-644-8080
  • Fax:
Mailing address:
  • Phone: 787-758-2780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number7822
License Number StatePR

VIII. Authorized Official

Name: DR. JOSE RAFAEL RODRIGUEZ-SANTANA
Title or Position: OWNER
Credential: MD
Phone: 787-644-8080