Healthcare Provider Details

I. General information

NPI: 1043762727
Provider Name (Legal Business Name): CORPORACION DE SALUD ASEGURADA POR NUESTRA ORGANIZACION SOLIDARIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2016
Last Update Date: 02/16/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA RAFAEL CORDERO ESQUINA TROCHE
CAGUAS PR
00725
US

IV. Provider business mailing address

PO BOX 1025
CAGUAS PR
00726-1025
US

V. Phone/Fax

Practice location:
  • Phone: 787-745-0340
  • Fax: 787-746-1780
Mailing address:
  • Phone: 787-745-0340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CESAR MONTIJO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-745-0340