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General NPI Number Information
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NPI Number | 1073730750
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Entity Type | Organization
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Legal Business Name | PALVAL MD'S PSC
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | HIMA PLAZA 1 500 AVE. DEGETAU STE 415
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City | CAGUAS
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State | PR
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Zip | 00725-7307
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Country | US
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Telephone | 787-743-1415
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Fax | 787-961-4662
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Provider Business Mailing Address
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Address Line | VENTANAS DE GURABO APTO. 263
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City | GURABO
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State | PR
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Zip | 00778-5301
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Country | US
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Telephone | 787-743-1415
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Fax | 787-961-4662
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIGUEL A PALACIOS
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Credential | M.D.
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Telephone | 787-743-1415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 6879
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 6879
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License Number State | PR
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