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General NPI Number Information
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NPI Number | 1114655784
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Entity Type | Organization
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Legal Business Name | CONSULTORIO MEDICINA DE FAMILIA, INC.
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | CARR. 146 KM 27.4 BO. CORDILLERA
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City | CIALES
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State | PR
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Zip | 00638
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Country | US
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Telephone | 787-871-3919
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Fax | 787-871-2376
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Provider Business Mailing Address
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Address Line | 25 CARR 149 UNIT 185
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City | CIALES
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State | PR
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Zip | 00638-3610
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Country | US
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Telephone | 787-871-3919
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. CARLOS M OTERO RIVERA I
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Credential | M.D.
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Telephone | 787-871-3919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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