Healthcare Provider Details

I. General information

NPI: 1649402967
Provider Name (Legal Business Name): CARIBE PATIENT SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2009
Last Update Date: 08/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS SUITE 304
ST THOMAS VI
00802-2615
US

IV. Provider business mailing address

PO BOX 9518
ST THOMAS VI
00801-2518
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-8819
  • Fax: 340-774-9051
Mailing address:
  • Phone: 340-774-8819
  • Fax: 340-774-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number100946
License Number StateVI

VIII. Authorized Official

Name: KENNETH L. FOX
Title or Position: MANAGER
Credential:
Phone: 340-774-8819