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General NPI Number Information
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NPI Number | 1346659935
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Entity Type | Organization
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Legal Business Name | BOARD CERTIFIED ONCOLOGY GROUP LLC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1519 AVE PONCE DE LEON SUITE 1201
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City | SAN JUAN
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State | PR
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Zip | 00909-1703
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Country | US
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Telephone | 787-919-7690
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Fax | 787-919-7694
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Provider Business Mailing Address
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Address Line | 1519 AVE PONCE DE LEON FIRST FEDERAL BUILDING
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City | SAN JUAN
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State | PR
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Zip | 00910
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Country | US
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Telephone | 787-919-7690
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Fax | 787-919-7694
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA PEREZ
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Credential | M.D.
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Telephone | 787-919-7690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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