Healthcare Provider Details

I. General information

NPI: 1881184935
Provider Name (Legal Business Name): CORPORACION DE SERVICIOS DE SALUD Y DESARROLLO SOCIOECONOMICO EL OTOAO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 140 KM 383 BO MAMEYES
UTUADO PR
00641
US

IV. Provider business mailing address

PO BOX 2113
UTUADO PR
00641-2113
US

V. Phone/Fax

Practice location:
  • Phone: 787-376-7659
  • Fax:
Mailing address:
  • Phone: 787-376-7659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO J VALENTIN
Title or Position: PRESIDENT
Credential:
Phone: 787-376-7659