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General NPI Number Information
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NPI Number | 1023736907
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY ONCOLOGY CARE GROUP LLC
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON STE 416
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City | SAN JUAN
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State | PR
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Zip | 00917-5026
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Country | US
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Telephone | 787-410-2877
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Fax |
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Provider Business Mailing Address
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Address Line | 735 AVE PONCE DE LEON STE 416
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City | SAN JUAN
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State | PR
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Zip | 00917-5026
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Country | US
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Telephone | 787-410-2877
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ALEXANDRA DEYA QUINQUILLA
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Credential | MD
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Telephone | 787-410-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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