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General NPI Number Information
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NPI Number | 1366868390
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Entity Type | Organization
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Legal Business Name | DR ARMANDO A. DOVAL ORTES CSP
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 03/14/2014
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Provider Practice Location Address
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Address Line | # 12 CALLE SOL
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-892-1333
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 159 AVENIDA MUNOZ RIVERA 1575
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-922-1906
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ARMANDO ANTONIO DOVAL
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Credential |
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Telephone | 787-922-1906
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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 | 16613
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License Number State | PR
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