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General NPI Number Information
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NPI Number | 1699763102
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Entity Type | Organization
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Legal Business Name | PEPINO HEALTH GROUP INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 126 CALLE PAVIA FERNANDEZ
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-2285
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Country | US
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Telephone | 787-280-1335
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Fax | 787-280-1335
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Provider Business Mailing Address
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Address Line | PO BOX 1537
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-1537
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Country | US
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Telephone | 787-280-1335
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Fax | 787-280-1335
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JIMMY OLIVERA
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Credential |
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Telephone | 787-280-1335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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