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General NPI Number Information
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NPI Number | 1124379409
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Entity Type | Organization
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Legal Business Name | DOCTORS EXPRESS CORP
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Dates
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Enumeration Date | 09/26/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | C5 CALLE GARDEN MDW GARDEN HILLS
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City | GUAYNABO
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State | PR
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Zip | 00966-2607
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Country | US
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Telephone | 787-599-5417
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Fax | 787-294-5559
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Provider Business Mailing Address
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Address Line | 1353 AVE LUIS VIGOREAUX PMB 677
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City | GUAYNABO
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State | PR
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Zip | 00966-2715
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Country | US
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Telephone | 787-599-5417
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Fax | 787-294-5559
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MRS. SHIRLEY ANN RIVERA IGLESIAS
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Credential |
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Telephone | 787-599-5417
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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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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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