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General NPI Number Information
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NPI Number | 1699213041
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Entity Type | Organization
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Legal Business Name | SERVICIOS CLINICOS DEL ESTE INC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | CARR 190 KM 1.8 BOCA CANGREJO
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-646-7769
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Fax |
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Provider Business Mailing Address
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Address Line | 41 URB COSTA VERDE PALMAS DEL MAR
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City | HUMACAO
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State | PR
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Zip | 00791-6037
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | ISMARY M GONZALEZ
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Credential |
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Telephone | 787-646-7769
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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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