Healthcare Provider Details

I. General information

NPI: 1124354816
Provider Name (Legal Business Name): HUTIMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2009
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SANTA AGUEDA 1700 URB SAN GERARDO
SAN JUAN PR
00926
US

IV. Provider business mailing address

1700 SANTA AGUEDA URB SAN GERARDO
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-1059
  • Fax:
Mailing address:
  • Phone: 787-754-1059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL F SOLER
Title or Position: PRESIDENT
Credential: MD
Phone: 787-754-1059