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General NPI Number Information
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NPI Number | 1295427409
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Entity Type | Organization
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Legal Business Name | ECO CLEAN PR LLC
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Dates
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Enumeration Date | 05/25/2023
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 575 CALLE DE DIEGO APT 510
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City | SAN JUAN
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State | PR
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Zip | 00924-3828
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Country | US
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Telephone | 787-560-3151
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Fax |
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Provider Business Mailing Address
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Address Line | 575 CALLE DE DIEGO APT 510
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City | SAN JUAN
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State | PR
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Zip | 00924-3828
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Country | US
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Telephone | 787-560-3151
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. SANDRA I. ROSA
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Credential |
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Telephone | 877-560-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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