Healthcare Provider Details

I. General information

NPI: 1689962292
Provider Name (Legal Business Name): CHIKOS - CENTRO DE TERAPIAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2011
Last Update Date: 07/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 URB VISTA VERDE
CAMUY PR
00627-3304
US

IV. Provider business mailing address

20 URB VISTA VERDE
CAMUY PR
00627-3304
US

V. Phone/Fax

Practice location:
  • Phone: 787-566-0084
  • Fax:
Mailing address:
  • Phone: 787-566-0084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number1118
License Number StatePR

VIII. Authorized Official

Name: XIOMARA CAJIGAS
Title or Position: DIRECTOR
Credential: MS, OTL
Phone: 787-566-0084