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General NPI Number Information
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NPI Number | 1285820613
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Entity Type | Organization
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Legal Business Name | ST JUDE MEDICAL PR LLC
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | MUNOZ RIVERA AVE. 654 PLAZA SUITE 1402
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-641-1111
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Fax | 787-641-1110
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Provider Business Mailing Address
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Address Line | PO BOX 366105
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City | SAN JUAN
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State | PR
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Zip | 00936-6105
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Country | US
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Telephone | 787-641-1111
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Fax | 787-641-1110
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Authorized Official
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Title or Position | SR. ACCOUNTANT
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Name | MRS. BRENDA LIZ FERNANDEZ
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Credential |
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Telephone | 787-641-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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