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General NPI Number Information
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NPI Number | 1184325508
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Entity Type | Organization
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Legal Business Name | COOPERATIVA DE MEDICOS OBSTETRAS GINECOLOGOS DE PUERTO RICO
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 1250 AVE PONCE DE LEON
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City | SAN JUAN
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State | PR
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Zip | 00907-3949
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Country | US
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Telephone | 787-433-7366
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Fax | 787-295-4822
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Provider Business Mailing Address
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Address Line | PO BOX 9781
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City | SAN JUAN
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State | PR
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Zip | 00908-0781
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Country | US
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Telephone | 787-433-7366
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Fax | 787-295-4822
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. NESTOR W CARPENZANO
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Credential |
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Telephone | 787-433-7366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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