Healthcare Provider Details

I. General information

NPI: 1962884817
Provider Name (Legal Business Name): DCO US LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2015
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CALLE MUNOZ RIVERA
JUNCOS PR
00777-3112
US

IV. Provider business mailing address

49 CALLE MUNOZ RIVERA
JUNCOS PR
00777-3112
US

V. Phone/Fax

Practice location:
  • Phone: 787-433-4447
  • Fax: 888-609-1739
Mailing address:
  • Phone: 787-743-0525
  • Fax: 787-561-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JORGE L LOPEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-433-4447