Healthcare Provider Details

I. General information

NPI: 1275365025
Provider Name (Legal Business Name): DEPARTAMENTO DE SALUD OFFICIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 08/19/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL UNIVERSITARIO DE ADULTOS CENTRO MEDICO, BARRIO MONACILOS
SAN JUAN PR
00922-2116
US

IV. Provider business mailing address

P.O. BOX 2116 AVE. AMERICAO MIRANDA
SAN JUAN PR
00922-2116
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-0101
  • Fax: 787-777-3456
Mailing address:
  • Phone: 787-754-0101
  • Fax: 787-777-3456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BIANCA CASTRO-VARGAS
Title or Position: ADMINISTRATOR
Credential: MHSA
Phone: 787-754-0101