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General NPI Number Information
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NPI Number | 1689683526
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Entity Type | Organization
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Legal Business Name | LLITERAS' PEDIATRIC GROUP, PSC
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 07/19/2010
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Provider Practice Location Address
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Address Line | AVE PONCE DE LEON HOSPITAL AUXILIO MUTUO
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City | SAN JUAN
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State | PR
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Zip | 00918-1000
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Country | US
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Telephone | 787-375-9090
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Fax |
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Provider Business Mailing Address
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Address Line | 587 YUNES ST. PALACIOS DEL RIO I
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City | TOA ALTA
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State | PR
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Zip | 00953-5022
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Country | US
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Telephone | 787-375-9090
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Fax | 787-999-5559
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OLGA M LLITERAS
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Credential |
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Telephone | 787-375-9090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 13897
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License Number State | PR
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