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General NPI Number Information
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NPI Number | 1689981888
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Entity Type | Organization
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Legal Business Name | SAN JORGE CHILDRENS MEDICAL SPEIALTIES
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 252 CALLE SAN JORGE STE 504
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City | SAN JUAN
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State | PR
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Zip | 00912-3241
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Country | US
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Telephone | 787-728-1575
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Fax | 787-726-0402
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Provider Business Mailing Address
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Address Line | 252 CALLE SAN JORGE SAN JORGE MEDICAL BLDG 504
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City | SANTURCE
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State | PR
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Zip | 00912-3239
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Country | US
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Telephone | 787-728-1575
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Fax | 787-726-0402
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Authorized Official
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Title or Position | ADMIN
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Name | CARMEN L VELEZ
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Credential |
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Telephone | 787-728-1575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 11147
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 5762
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9083
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 9183
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License Number State | PR
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 12902
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License Number State | PR
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 13693
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License Number State | PR
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Taxonomy #7
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number |
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License Number State |
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