Healthcare Provider Details

I. General information

NPI: 1881084424
Provider Name (Legal Business Name): SALA EMRG CDT CULEBRA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WILLIAM FONT FINAL ST.
CULEBRA PR
00775
US

IV. Provider business mailing address

PO BOX 70184
SAN JUAN PR
00936-8184
US

V. Phone/Fax

Practice location:
  • Phone: 787-742-0001
  • Fax:
Mailing address:
  • Phone: 787-765-2929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RODE VELEZ
Title or Position: SUPERVISORA ENFERMERIA
Credential:
Phone: 787-742-0001