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General NPI Number Information
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NPI Number | 1952387524
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN RESP CARE SERV
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 1451 ASHFORD 2ND FLOOR
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City | SAN JUAN
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State | PR
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Zip | 00907-1511
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Country | US
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Telephone | 787-725-7860
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Fax | 787-722-3630
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Provider Business Mailing Address
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Address Line | PMB 423 1357 ASHFORD AVE SUITE 2
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City | SAN JUAN
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State | PR
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Zip | 00907-1420
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Country | US
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Telephone | 787-725-7860
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Fax | 787-722-3630
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Authorized Official
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Title or Position | ADMINISTRATIVE PARTNER
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Name | DR. BELISARIO MATTA DE JUAN
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Credential | M.D.
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Telephone | 787-725-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 4154
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License Number State | PR
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