Healthcare Provider Details
I. General information
NPI: 1659870640
Provider Name (Legal Business Name): CARIBBEAN STEWARDSHIP & INFUSION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2018
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2053 PONCE BY PASS CENTRO CARIBE BLDG. SUITE 205
PONCE PR
00717
US
IV. Provider business mailing address
PO BOX 712
MERCEDITA PR
00715-0712
US
V. Phone/Fax
- Phone: 787-987-8050
- Fax: 787-987-8050
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | 167798 |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
LUIS
JORGE
LUGO VELEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-688-7327