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General NPI Number Information
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NPI Number | 1790128080
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Entity Type | Organization
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Legal Business Name | CLINICA EL BUEN SAMARITANO,INC.
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Dates
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Enumeration Date | 04/17/2013
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | CARR.152 KM 1.9 BO. QUEBRADILLAS
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City | BARRANQUITAS
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State | PR
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Zip | 00794
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Country | US
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Telephone | 787-857-0430
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Fax | 787-857-0430
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Provider Business Mailing Address
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Address Line | PMB 201 P. O.BOX 1999
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City | BARRANQUITAS
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State | PR
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Zip | 00794
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Country | US
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Telephone | 787-857-0430
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Fax | 787-857-0430
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Authorized Official
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Title or Position | PRESIDENTA
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Name | MISS SAEZ HERNANDEZ SANDRA
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Credential | SECRETARIA
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Telephone | 787-857-0430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | PR
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