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General NPI Number Information
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NPI Number | 1407978307
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Entity Type | Organization
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Legal Business Name | DEPARTAMENTO DE SALUD OFICIAL
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 05/12/2020
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Provider Practice Location Address
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Address Line | HOSPITAL HIMMA SAN PABLO EDIFICIO CLINICAS EXTERNAS, SEGUNDO PISO
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City | FAJARDO
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State | PR
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Zip | 00738
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Country | US
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Telephone | 787-765-2929
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Fax | 787-863-5437
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Provider Business Mailing Address
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Address Line | #100 URBANIZACION SANTA JUANITA AVE LAUREL
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City | BAYAMON
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State | PR
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Zip | 00956-4816
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Country | US
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Telephone | 787-765-2929
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Fax | 787-863-5437
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Authorized Official
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Title or Position | DIRECTOR EJECUTIVO
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Name | DR. CUIDUVEL DURAN
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Credential | MD
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Telephone | 787-765-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State | PR
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