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General NPI Number Information
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NPI Number | 1154199396
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Entity Type | Organization
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Legal Business Name | PODIATRY AND DIABETIC CARE CENTER INC.
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | CALLE DR. TROYER A-2 BO. CAONILLAS
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City | AIBONITO
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State | PR
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Zip | 00705
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Country | US
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Telephone | 787-535-0335
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6425
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City | BAYAMON
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State | PR
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Zip | 00960-5425
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Country | US
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Telephone | 787-535-0335
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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. SAMUEL ALVAREZ GONZALEZ
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Credential | DPM
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Telephone | 787-630-0804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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