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General NPI Number Information
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NPI Number | 1306098686
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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 | 10/17/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | CENTRO PEDIATRICO PONCE 931 CARR 14 BO MACHUELO AVENIDA TITO CASTRO
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City | PONCE
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State | PR
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Zip | 00716-4717
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Country | US
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Telephone | 787-842-5884
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Fax | 787-842-5802
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Provider Business Mailing Address
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Address Line | AVENIDA TITO CASTRO 931 CARR. 14 BO. MACHUELO CENTRO PEDIATRICO DE PONCE
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-842-5884
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Fax | 787-842-5802
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Authorized Official
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Title or Position | DIRECTORA EJECUTIVA
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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