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General NPI Number Information
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NPI Number | 1619918331
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Entity Type | Organization
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Legal Business Name | DORADO COMMUNITY HEALTH INC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 400 CARR 698 BO. MAMEYAL
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City | DORADO
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State | PR
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Zip | 00646-3301
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Country | US
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Telephone | 787-796-3330
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Fax | 787-915-7597
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Provider Business Mailing Address
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Address Line | PO BOX 419
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-796-3330
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Fax | 787-915-7597
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Authorized Official
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Title or Position | DIRECTOR MEDICO
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Name | DR. LUIS M GONZALEZ BERMUDEZ
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Credential | MD
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Telephone | 787-316-1212
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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 | 861
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License Number State | PR
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