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General NPI Number Information
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NPI Number | 1245448109
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Entity Type | Organization
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Legal Business Name | CAROLINA NUCLEAR
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | AVENUE MONSERRATE VALLE ARRIBA HEIGHTS AC8
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-757-5958
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Fax | 787-757-6190
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Provider Business Mailing Address
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Address Line | PO BOX 3457
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City | CAROLINA
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State | PR
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Zip | 00984-3457
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Country | US
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Telephone | 787-757-5985
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Fax | 787-757-6190
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. NIVIA SOUFFRONT
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Credential |
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Telephone | 787-721-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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