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General NPI Number Information
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NPI Number | 1093861643
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Entity Type | Organization
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Legal Business Name | CONS MEDICO GINECOLOGIA Y OBSTETRICIA
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CALLE PALMER #18 ESQ. BLANCO SOSA
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City | CANOVANAS
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State | PR
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Zip | 00729-0011
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Country | US
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Telephone | 787-256-0132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10000
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City | CANOVANAS
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State | PR
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Zip | 00729-0011
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Country | US
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Telephone | 787-256-0132
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ZULMA IRIS JURADO AGOSTO
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Credential | M.D
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Telephone | 17872560132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11620
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License Number State | PR
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