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General NPI Number Information
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NPI Number | 1942656350
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Entity Type | Organization
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Legal Business Name | MARALEC,CSP
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 35 CALLE CASTILLO
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City | PONCE
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State | PR
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Zip | 00730-3747
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Country | US
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Telephone | 787-848-0606
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Fax | 787-848-0616
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Provider Business Mailing Address
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Address Line | PO BOX 7105 PMB 595
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City | PONCE
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State | PR
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Zip | 00732-7105
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Country | US
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Telephone | 787-848-0606
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Fax | 787-848-0616
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOSE A CANGIANO
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Credential | MD
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Telephone | 787-848-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 13250
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License Number State | PR
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