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General NPI Number Information
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NPI Number | 1639396484
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Entity Type | Organization
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Legal Business Name | CENTRO DE DIAGNOSTICO Y TRATAMIENTO PATILLAS
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CDT PATILLAS CALLE RIEFKOL CARR. 3 KM. 27.1
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City | PATILLAS
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-839-4360
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Fax | 787-271-0004
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Provider Business Mailing Address
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Address Line | CDT PATILLAS P O BOX 697
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City | PATILLAS
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State | PR
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Zip | 00723
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Country | US
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Telephone | 787-839-4360
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Fax | 787-271-0004
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Authorized Official
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Title or Position | DIRECTORA EJECUTIVA
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Name | MRS. CARMEN R RODRIGUEZ
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Credential | MPA
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Telephone | 787-771-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 55
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License Number State | PR
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