Healthcare Provider Details

I. General information

NPI: 1891970562
Provider Name (Legal Business Name): MUNICIPIO DE CIALES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CALLE HOSPITAL
CIALES PR
00638-3310
US

IV. Provider business mailing address

PO BOX 1408
CIALES PR
00638-1408
US

V. Phone/Fax

Practice location:
  • Phone: 787-871-2003
  • Fax:
Mailing address:
  • Phone: 787-871-2003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: LUIS O MALDONADO RODRIGUEZ
Title or Position: MAYOR
Credential:
Phone: 787-871-3100