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General NPI Number Information
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NPI Number | 1699169607
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Entity Type | Organization
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Legal Business Name | PLAZA DEL CARMEN MEDICAL SERVICES INC.
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | CARR 891 KM13 PLAZA DEL CARMEN BO. PUEBLO
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone | 787-859-1901
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 620
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City | COROZAL
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State | PR
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Zip | 00783-0620
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Country | US
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Telephone | 787-859-1901
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIGUEL ANGEL ORTIZ CALDERO
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Credential | 6237
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Telephone | 787-859-1901
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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 | 109
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License Number State | PR
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