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General NPI Number Information
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NPI Number | 1336310655
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Entity Type | Individual
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Provider Name | JACQUELINE J THOMAS ATOL
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Gender | Female
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | AVE. LAUREL, LOMAS VERDES HOSPITAL REGIONAL
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-780-6090
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 9178
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City | COROZAL
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State | PR
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Zip | 00783-6138
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 377
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License Number State | PR
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