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General NPI Number Information
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NPI Number | 1710281977
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Entity Type | Organization
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Legal Business Name | NUBISA
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | H17 AVE MUNOZ MARIN
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City | CAGUAS
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State | PR
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Zip | 00725-6159
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Country | US
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Telephone | 787-653-9877
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Fax |
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Provider Business Mailing Address
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Address Line | H17 AVE MUNOZ MARIN
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City | CAGUAS
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State | PR
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Zip | 00725-6159
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Country | US
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Telephone | 787-653-9877
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIRTA YARIS RODRIGUEZ
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Credential | LND
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Telephone | 787-633-0475
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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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