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General NPI Number Information
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NPI Number | 1225254287
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Entity Type | Organization
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Legal Business Name | SECCION A NINOS CON NECESIDADES ESPECIALES
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CENTRO PEDIATRICO DE FAJARDO CALLE E SUITE 77 URB MONTEBRISAS
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-704-7066
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Fax | 787-746-2898
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Provider Business Mailing Address
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Address Line | CENTRO PEDIATRICO DE FAJARDO CALLE E SUITE 77 URB MONTEBRISAS
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-704-7066
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Fax | 787-746-2898
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Authorized Official
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Title or Position | DIRETOR EJECUTIVO
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Name | MRS. CARMEN R RODRIGUEZ
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Credential | MPA
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Telephone | 787-771-2100
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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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