Healthcare Provider Details

I. General information

NPI: 1598985889
Provider Name (Legal Business Name): DEPARTAMENTO DE SALUD OFICIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 07/10/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRT. 188 KM5 HM 6 INT. 187
LOIZA PR
00772
US

IV. Provider business mailing address

PO BOX 70184
SAN JUAN PR
00936-8184
US

V. Phone/Fax

Practice location:
  • Phone: 787-876-2245
  • Fax: 787-771-2295
Mailing address:
  • Phone: 787-765-2929
  • Fax: 787-771-2295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number5365-05
License Number StatePR

VIII. Authorized Official

Name: YESAREL Y. PESANTE SANCHEZ
Title or Position: SECRETARIO AUXILIAR II
Credential:
Phone: 787-765-2929