Healthcare Provider Details

I. General information

NPI: 1225049794
Provider Name (Legal Business Name): JEFFREY WESNER TOUSSAINT CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

10 CALLE CASIA PULMONARY SECTION - 111E
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

PO BOX 1454
OROCOVIS PR
00720-1454
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax: 787-641-5710
Mailing address:
  • Phone: 787-641-7582
  • Fax: 787-641-5710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number1336
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: