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General NPI Number Information
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NPI Number | 1932454204
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Entity Type | Organization
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Legal Business Name | INSTITUTO REGIONAL DEL CORAZON
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Dates
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Enumeration Date | 07/23/2012
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Last Update Date | 07/23/2012
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Provider Practice Location Address
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Address Line | AVENIDA INDEPENDENCIA # 2
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City | SAN PEDRO DE MACORIS
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State | SAN PEDRO DE MACORIS
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Zip | 21000
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Country | DO
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Telephone | 809-246-1806
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Fax |
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Provider Business Mailing Address
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Address Line | AVENIDA INDEPENDENCIA # 2
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City | SAN PEDRO DE MACORIS
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State | SAN PEDRO DE MACORIS
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Zip | 21000
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Country | DO
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DOMINGO JEREZ JAVIER
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Credential | M.D.
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Telephone | 809-246-1806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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