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General NPI Number Information
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NPI Number | 1396165064
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Entity Type | Organization
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Legal Business Name | CENTRO PEDIATRICO DEL CARIBE
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 2279 PBP CARIBBEAN MEDICAL CENTRE SUITE 2312-2
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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 | 787-231-7697
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Fax | 787-709-4676
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Provider Business Mailing Address
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Address Line | PO BOX 1183
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City | YAUCO
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State | PR
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Zip | 00698-1183
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Country | US
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Telephone | 787-231-7697
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Fax | 787-709-4676
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIELA TERESA PACHECO
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Credential |
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Telephone | 787-231-7697
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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 |
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License Number State |
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