Healthcare Provider Details
I. General information
NPI: 1790267789
Provider Name (Legal Business Name): NORTH FLORIDA HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
B24 CALLE 3
MANATI PR
00674-5409
US
IV. Provider business mailing address
PO BOX 77
MANATI PR
00674-0077
US
V. Phone/Fax
- Phone: 787-884-3065
- Fax: 787-854-1687
- Phone: 787-884-3065
- Fax: 787-854-1687
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0901X |
| Taxonomy | Public Health & General Preventive Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VICTOR
L
DELGADO COLON
Title or Position: PRESIDENT
Credential: MD
Phone: 787-884-3065