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General NPI Number Information
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NPI Number | 1619091758
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Entity Type | Organization
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Legal Business Name | MEDICOS VISITANTES CSP
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | LAGOS DEL NORTE CONDO OFICINA 303
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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 | 787-784-8139
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | BAYAMON
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State | PR
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Zip | 00960-0760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | FERMIN HERNANDEZ
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Credential | MD
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Telephone | 787-784-8139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | PR
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