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General NPI Number Information
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NPI Number | 1184014540
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Entity Type | Organization
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Legal Business Name | CLINICA DE MEDICINA ESPECIALIZADA C.S.P.
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | PR-140, KM. 57.4 BO. SAN AGUSTIN
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City | FLORIDA
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State | PR
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Zip | 00650-0000
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Country | US
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Telephone | 939-440-0114
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Fax | 787-680-7814
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Provider Business Mailing Address
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Address Line | PO BOX 2360
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City | MANATI
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State | PR
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Zip | 00674-2360
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Country | US
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Telephone | 939-440-0114
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Fax | 787-680-7814
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBIN SANTIAGO-DELGADO
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Credential | M.D.
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Telephone | 939-440-0114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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