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General NPI Number Information
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NPI Number | 1306859541
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Entity Type | Organization
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Legal Business Name | DINAMICA QUIRURGICA DEL ESTE
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | EDIFICIO MEDICO DEL ESTE AVE. GENERAL VALERO
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City | FAJARDO
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State | PR
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Zip | 00738-7005
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Country | US
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Telephone | 787-860-3386
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 265 PO BOX 70005
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City | FAJARDO
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State | PR
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Zip | 00738-7005
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Country | US
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Telephone | 787-860-3386
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. YNGRID LITHGOW
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Credential |
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Telephone | 787-860-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 6201
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11335
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License Number State | PR
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