=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780623108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NH ROTA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2006
-----------------------------------------------------
Last Update Date | 06/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PSC 819 BOX 18
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AE
-----------------------------------------------------
Zip | 09645-0018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 34956823515
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | USNH ROTA SPAIN PSC 819 BOX 18
-----------------------------------------------------
City | FPO
-----------------------------------------------------
State | AE
-----------------------------------------------------
Zip | 09645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | UBO MANAGER
-----------------------------------------------------
Name | MARCO GRANADO CABALLERO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 11-349-5682
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2865M2000X
-----------------------------------------------------
Taxonomy Name | Military General Acute Care Hospital
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------