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General NPI Number Information
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NPI Number | 1467859736
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Entity Type | Organization
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Legal Business Name | CDT MARICAO MEDICAL CENTER LLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 9 AVE LUCHETTI
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City | MARICAO
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State | PR
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Zip | 00606-1310
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Country | US
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Telephone | 787-940-4685
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Fax |
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Provider Business Mailing Address
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Address Line | AVE. LUCHETTI NUM. 9
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City | MARICAO
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State | PR
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Zip | 00606
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Country | US
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Telephone | 787-940-4685
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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. EDRICK RAMIREZ
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Credential | MD
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Telephone | 787-940-4685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 49
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License Number State | PR
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