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General NPI Number Information
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NPI Number | 1891232633
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Entity Type | Organization
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Legal Business Name | IPPA SALUD COOP
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 20 OFFICE PARK RD EDIFICIO ASSERTUS SUITE 302
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-751-5979
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Fax | 787-281-7669
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Provider Business Mailing Address
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Address Line | PO BOX 70169
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City | SAN JUAN
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State | PUERTO RICO
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Zip | 00936
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Country | UM
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Telephone | 787-751-5979
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Fax | 787-281-7669
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. EDUARDO RODRIGUEZ VAZQUEZ
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Credential |
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Telephone | 787-740-0713
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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 |
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