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General NPI Number Information
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NPI Number | 1750737482
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Entity Type | Organization
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Legal Business Name | GO GOGO FOUNDATION CORP.
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 1123 AVE HOSTOS
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City | PONCE
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State | PR
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Zip | 00717-0952
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Country | US
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Telephone | 787-974-2679
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 801530
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City | COTO LAUREL
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State | PR
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Zip | 00780-1530
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Country | US
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Telephone | 787-974-2679
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Fax |
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Authorized Official
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Title or Position | DIRETOR
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Name | MR. ULISES A. CLAVELL
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Credential |
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Telephone | 787-974-2679
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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 |
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License Number State |
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