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General NPI Number Information
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NPI Number | 1215061148
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Entity Type | Organization
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Legal Business Name | DEPARTAMENTO DE SALUD OFICIAL
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | PREDIOS CENTRO MEDICO MAYAGUEZ 410 AVE HOSTOS CARR. # 22
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City | MAYAGUEZ
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State | PR
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Zip | 00682-1522
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Country | US
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Telephone | 787-834-2110
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Fax | 787-832-6015
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Provider Business Mailing Address
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Address Line | PO BOX 193044
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City | SAN JAUN
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State | PR
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Zip | 00919-3044
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Country | US
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Telephone | 787-945-1472
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Fax | 787-250-9265
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Authorized Official
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Title or Position | DIRECTOR EJECUTIVO
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Name | DR. CUIDUVEL DURAN
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Credential | MD
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Telephone | 787-945-1472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | PR
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