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General NPI Number Information
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NPI Number | 1427435536
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICAL CENTER
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | CARR 867 KM 2.2 AVE. SABANA SECA
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-270-3330
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Fax | 787-875-4904
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Provider Business Mailing Address
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Address Line | PO BOX 1103
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City | COMERIO
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State | PR
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Zip | 00782
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Country | US
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Telephone | 787-380-1122
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Fax | 787-875-4904
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Authorized Official
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Title or Position | CHIEF OPERATOR
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Name | MR. JUAN C HEREDIA
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Credential | BSPH
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Telephone | 787-380-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 048073
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License Number State | PR
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