Healthcare Provider Details

I. General information

NPI: 1447629100
Provider Name (Legal Business Name): NOHSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1-23 AVE PRINCIPAL URB BARALT SUITE 1
FAJARDO PR
00738
US

IV. Provider business mailing address

267 CALLE SIERRA MORENA PMB 451
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-863-7646
  • Fax: 787-860-7357
Mailing address:
  • Phone: 787-884-7202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EULOGIO BATISTA
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-884-7202