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General NPI Number Information
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NPI Number | 1679227003
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Entity Type | Organization
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Legal Business Name | TOA BAJA MEDICAL PLAZA INC
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | CARRETERA #2 KM 18.4 BO. CANDELARIA AREN
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City | TOA BAJA
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State | PR
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Zip | 00951-0001
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Country | US
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Telephone | 787-979-9189
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Fax | 787-979-9168
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Provider Business Mailing Address
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Address Line | PMB 164 PO BOX 4002
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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 | 787-306-1900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARLING T PANTOJA
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Credential |
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Telephone | 787-306-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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