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General NPI Number Information
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NPI Number | 1912109448
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Entity Type | Organization
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Legal Business Name | CENTRO DR. EDWIN F. GIRAU NIEVES
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CALLE EMILIO GIBOYEAUX # 28
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-883-2766
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Fax | 787-883-2725
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Provider Business Mailing Address
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Address Line | SABANA BRANCH P. O. BOX 948718
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City | VEGA BAJA
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State | PR
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Zip | 00694
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Country | US
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Telephone | 787-883-2711
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Fax | 787-883-2725
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Authorized Official
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Title or Position | SECRETARIA
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Name | MRS. EVELYN SAMO
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Credential |
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Telephone | 787-883-2766
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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 | 10829
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License Number State | PR
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