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General NPI Number Information
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NPI Number | 1134374036
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Entity Type | Organization
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Legal Business Name | CORPORACION DE SERVICIOS DE SALUD Y MEDICINA AVANZADA (COSSMA)
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | AVE. EL JIBARO KM. 13.5 CARR. 172
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City | CIDRA
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State | PR
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Zip | 00739-1330
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Country | US
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Telephone | 787-739-8182
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Fax | 787-739-8190
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Provider Business Mailing Address
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Address Line | PO BOX 1330 AVE. EL JIBARO CARR. 172 KM. 13.5
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City | CIDRA
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State | PR
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Zip | 00739-1330
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Country | US
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Telephone | 787-739-8182
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Fax | 787-739-8190
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Authorized Official
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Title or Position | EXECUTOVE DIRECTOR
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Name | MS. ISOLINA MIRANDA
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Credential |
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Telephone | 787-739-8182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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