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General NPI Number Information
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NPI Number | 1801225537
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Entity Type | Organization
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Legal Business Name | DC HEALTH CARE LLC
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 11/04/2013
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Provider Practice Location Address
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Address Line | CHALETS DE LA PLAYA BLGD 10 APT 170
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 973-489-0728
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Fax |
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Provider Business Mailing Address
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Address Line | CHALETS DE LA PLAYA BLGD 10 APT 170
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 973-489-0728
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL DEMETRIO DSTTEFFANO
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Credential | M.D
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Telephone | 973-489-0728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 18562
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License Number State | PR
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