Healthcare Provider Details

I. General information

NPI: 1740409580
Provider Name (Legal Business Name): ORIENTAL PEDIATRICS EMERGENCY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GENERAL VALERO AVE. KM. 2.6 ROAD #194 BUILDING #404
FAJARDO PR
00738
US

IV. Provider business mailing address

ESTANCIAS DE SAN FERNANDO STREET #4 B-17
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-863-0505
  • Fax:
Mailing address:
  • Phone: 787-863-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS R ALVAREZ
Title or Position: PRESIDENT
Credential: MD MHSA
Phone: 787-863-0505