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General NPI Number Information
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NPI Number | 1669815254
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Entity Type | Organization
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Legal Business Name | TRUST MEDICAL AND ONCOLOGY CENTER PSC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 4PN4 VIA JOSEFINA VILLA FONTANA
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City | CAROLINA
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State | PR
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Zip | 00983-4828
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Country | US
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Telephone | 787-633-0017
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Fax | 787-710-9886
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Provider Business Mailing Address
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Address Line | PO BOX 363305
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City | SAN JUAN
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State | PR
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Zip | 00936-3305
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Country | US
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Telephone | 787-633-0017
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Fax | 787-710-9886
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Authorized Official
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Title or Position | MD
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Name | DR. ALVARO A. TALAVERA
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Credential | MD
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Telephone | 787-633-0017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 13091
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License Number State | PR
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