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General NPI Number Information
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NPI Number | 1780801563
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Entity Type | Organization
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Legal Business Name | CENTRO DE DIAGNOSTICO Y TRATAMIENTO YABUCOA
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CDT YABUCOA CARR.901 CALLE SATURNINO RODRIGUEZ #100
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City | YABUCOA
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State | PR
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Zip | 00767
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Country | US
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Telephone | 787-893-0480
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Fax | 787-771-2295
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Provider Business Mailing Address
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Address Line | CDT YABUCOA P O BOX 8548
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City | YABUCOA
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-893-0480
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Fax | 787-771-2295
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Authorized Official
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Title or Position | DIRECTORA EJECUTIVA
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Name | MRS. CARMEN R RODRIGUEZ
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Credential | MPA
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Telephone | 787-771-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 63
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License Number State | PR
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