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General NPI Number Information
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NPI Number | 1255464293
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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 | 03/13/2007
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | ANTIGUO HOSPITAL DE DISTRITO HOSPITAL DR. JOSE' GANDARA, CARR. 14, SO MACHUELO
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City | PONCE
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-259-4731
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Fax | 787-259-3998
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Provider Business Mailing Address
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Address Line | #100 URBANIZAUOR SANTA JUANITA AVENIDE LAUREL
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City | BAYAMON
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State | PR
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Zip | 00956-4816
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Country | US
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Telephone | 872-594-7307
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Fax | 787-259-3998
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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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