Healthcare Provider Details

I. General information

NPI: 1457670473
Provider Name (Legal Business Name): SOCIEDAD DE SERVICIOS DE SALUD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 AVE BORINQUEN
SAN JUAN PR
00915-3814
US

IV. Provider business mailing address

PO BOX 14457
SAN JUAN PR
00916-4457
US

V. Phone/Fax

Practice location:
  • Phone: 787-268-4171
  • Fax: 787-727-3695
Mailing address:
  • Phone: 787-268-4171
  • Fax: 787-727-3695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. HECTOR L. VILLANUEVA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 787-268-4171