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General NPI Number Information
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NPI Number | 1972536258
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Entity Type | Organization
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Legal Business Name | ALTERNATIVA MODERNA DE MEDICINA ESPECIALIZADA INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 877 CAMPO RICO AVENUE
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City | SAN JUAN
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State | PUERTO RICO
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Zip | 99024
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Country | UM
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Telephone | 787-701-4938
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Fax | 787-701-4790
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Provider Business Mailing Address
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Address Line | 877 CAMPO RICO AVENUE
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City | SAN JUAN
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State | PUERTO RICO
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Zip | 00924
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Country | UM
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Telephone | 787-701-4938
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Fax | 787-701-4790
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LILIA E OTERO
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Credential |
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Telephone | 787-464-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PR
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