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General NPI Number Information
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NPI Number | 1326160227
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Entity Type | Organization
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Legal Business Name | INSTITUTO DE HEMATOLOGIA Y ONCOLOGIA DEL TURABO
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | SAN JUAN BAUTISTA MEDICAL CENTER RD. 172, URB. TURABO GARDENS
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City | CAGUAS
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State | PR
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Zip | 00725-0000
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Country | US
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Telephone | 787-258-5858
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Fax | 787-258-5858
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Provider Business Mailing Address
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Address Line | PMB 331 PO BOX 4961
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City | CAGUAS
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State | PR
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Zip | 00726-4961
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Country | US
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Telephone | 787-258-5858
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Fax | 787-258-5858
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Authorized Official
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Title or Position | OWNER
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Name | DR. EVELYN MARIE FONSECA
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Credential | M.D.
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Telephone | 787-258-5858
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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 | 9601
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License Number State | PR
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