Healthcare Provider Details

I. General information

NPI: 1386281053
Provider Name (Legal Business Name): YAUCO HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#92 CALLE SOL ESQUINA TORRES #75
PONCE PR
00730
US

IV. Provider business mailing address

PO BOX 5643
YAUCO PR
00698-5643
US

V. Phone/Fax

Practice location:
  • Phone: 787-856-1000
  • Fax: 787-267-6614
Mailing address:
  • Phone: 787-856-1000
  • Fax: 787-267-6614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: DINORAH HERNANDEZ
Title or Position: DIRECTOR EXECUTIVE
Credential:
Phone: 787-856-1000