Healthcare Provider Details

I. General information

NPI: 1396984050
Provider Name (Legal Business Name): ONCOLOGY INNOVATIONS AND INFUSIONS, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. GENERAL VALERO 410 TORRE MEDICA HIMA SAN PABLO SUITE 303
FAJARDO PR
00738
US

IV. Provider business mailing address

PO BOX 786
FAJARDO PR
00738-0786
US

V. Phone/Fax

Practice location:
  • Phone: 787-801-0000
  • Fax: 787-860-7105
Mailing address:
  • Phone: 787-801-0000
  • Fax: 787-860-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number12895
License Number StatePR

VIII. Authorized Official

Name: DR. LUZ N CORTES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-342-9959