Healthcare Provider Details

I. General information

NPI: 1497416945
Provider Name (Legal Business Name): DEPARTAMENTO DE SALUD OFICIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PUERTO RICO MEDICAL CENTER
RIO PIEDRAS PR
00919-1079
US

IV. Provider business mailing address

PO BOX 191079
SAN JUAN PR
00919-1079
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3232
  • Fax:
Mailing address:
  • Phone: 787-474-0333
  • Fax: 787-522-3969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. GISSELLE KARINA VAN DERDYS ARROYO
Title or Position: EXECUTIVE DIRECTOR
Credential: MHSA
Phone: 787-474-0333