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General NPI Number Information
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NPI Number | 1558797712
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Entity Type | Organization
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Legal Business Name | PROGRESA EN TODO CSP
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Dates
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Enumeration Date | 09/19/2013
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Last Update Date | 09/19/2013
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Provider Practice Location Address
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Address Line | BAYAMON MEDICAL MALL STE 11
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City | BAYAMON
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State | PR
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Zip | 00959-7200
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Country | US
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Telephone | 787-780-8715
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Fax | 787-780-8716
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Provider Business Mailing Address
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Address Line | PO BOX 705
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 787-780-8715
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Fax | 787-780-8716
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FERNADO ZAPATER RODRIGUEZ
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Credential | MD
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Telephone | 787-780-8715
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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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