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General NPI Number Information
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NPI Number | 1023539061
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Entity Type | Organization
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Legal Business Name | CLINICAL SOLUTIONS LLC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1395 CALLE SAN RAFAEL PISO 7
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City | SAN JUAN
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State | PR
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Zip | 00909
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Country | US
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Telephone | 787-644-0174
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Fax | 787-999-2944
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Provider Business Mailing Address
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Address Line | 1395 CALLE SAN RAFAEL FL 7
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City | SAN JUAN
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State | PR
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Zip | 00909-2518
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Country | US
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Telephone | 787-644-0174
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Fax | 787-999-2944
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Authorized Official
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Title or Position | MD
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Name | JORGE VALDESUSO
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Credential | MD
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Telephone | 787-644-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 11470
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 400006
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License Number State | PR
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