Healthcare Provider Details

I. General information

NPI: 1780976555
Provider Name (Legal Business Name): MUNICIPIO DE SAN GERMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 102 K.M 33.6 URB. SANTA MARIA CALLE GOLONDRINA
SAN GERMAN PR
00683
US

IV. Provider business mailing address

AVE. UNIVERSIDAD INTERAMERICANA #136 PO. BOX 85
SAN GERMAN PR
00683
US

V. Phone/Fax

Practice location:
  • Phone: 787-892-5620
  • Fax:
Mailing address:
  • Phone: 787-892-5620
  • Fax: 787-892-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberTC-AMB-441
License Number StatePR

VIII. Authorized Official

Name: MRS. ISIDRO NEGRON
Title or Position: MAYOR
Credential:
Phone: 787-892-3500