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General NPI Number Information
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NPI Number | 1700303468
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Entity Type | Organization
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Legal Business Name | CARIBE PHYSICIANS PLAZA CORPORATION
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 151 AVE OSVALDO MOLINA
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City | FAJARDO
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State | PR
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Zip | 00738-4013
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Country | US
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Telephone | 787-801-0081
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Fax | 787-522-3580
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Provider Business Mailing Address
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Address Line | PO BOX 70006
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City | FAJARDO
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State | PR
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Zip | 00738-7006
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Country | US
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Telephone | 787-801-0081
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Fax | 787-801-0087
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANA J. OLIVERAS
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Credential |
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Telephone | 787-801-0081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 18
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License Number State | PR
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