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General NPI Number Information
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NPI Number | 1417439456
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Entity Type | Organization
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Legal Business Name | PUERTO RICO HEALTH MANAGEMENT
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | ESCORIAL OFFICE BUILDING ONE 1400 AVE. DE DIEGO SUITE 300
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City | CAROLINA
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State | PR
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Zip | 00987-4703
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Country | US
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Telephone | 787-444-4908
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Fax |
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Provider Business Mailing Address
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Address Line | ESCORIAL OFFICE BUILDING ONE 1400 AVE. DE DIEGO SUITE 300
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City | CAROLINA
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State | PR
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Zip | 00987-4703
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Country | US
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Telephone | 787-444-4908
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Fax |
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Authorized Official
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Title or Position | VP
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Name | ALEX CARRASQUILLO
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Credential |
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Telephone | 787-444-4908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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