Healthcare Provider Details

I. General information

NPI: 1952364093
Provider Name (Legal Business Name): ANGEL TOMAS NOLASCO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL SAN FRANCISCO
RIO PIEDRAS PR
00926
US

IV. Provider business mailing address

G.P.O BOX 3258 CAROLINA P.R 00984 AVE MONSERRATE BH-16 VALLE ARRIBA HEIGHTS CAROLINA PR
CAROLINA PR
00984
US

V. Phone/Fax

Practice location:
  • Phone: 787-767-5100
  • Fax: 787-767-8303
Mailing address:
  • Phone: 787-762-9516
  • Fax: 787-750-2502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3778
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: