Healthcare Provider Details

I. General information

NPI: 1144358441
Provider Name (Legal Business Name): DEPARTAMENTO DE SALUD OFICIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO CELSO BARBOSA PRIMER PISO HOSPITAL DE TRAUMA CENTRO MEDICO, BO. MONACILLOS, RIO PIEDRAS
SAN JUAN PR
00918
US

IV. Provider business mailing address

#100 URBANIZACION SANTA JUANITA AVENIDA LAUREL
BAYAMON PR
00956-4816
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-8128
  • Fax: 787-754-8127
Mailing address:
  • Phone: 787-754-8128
  • Fax: 787-754-8127

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. CUIDUVEL DURAN
Title or Position: DIRECTOR EJECUTIVO
Credential: MD
Phone: 787-945-1472