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General NPI Number Information
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NPI Number | 1992269302
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Entity Type | Organization
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Legal Business Name | NEFROMD PSC.
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 01/30/2019
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Provider Practice Location Address
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Address Line | COROZAL SHOPPING CENTER CARR 159 KM 23.7 BO DOS BOCAS SECTOR LOMA LINDA
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City | COROZAL
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State | PR
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Zip | 00783
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Country | US
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Telephone | 787-595-3315
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Fax |
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Provider Business Mailing Address
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Address Line | 147 CALLE DORADO URB ESTANCIA DE MANATI
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City | MANATI
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State | PR
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Zip | 00674
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Country | US
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Telephone | 787-595-3315
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | EDGAR HERNANDEZ-MONTALVO
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Credential | MD
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Telephone | 787-595-3315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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