MEDICARE: SALUD FAMILIAR EN EL HOGAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	20	PR

General Provider Information

NPI Number	:	1285747980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALUD FAMILIAR EN EL HOGAR

Provider Business Mailing Address
First Line	:	PO BOX 19150
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00910-1150
Country	:	US
Telephone Number	:	787-771-3010
Fax Number	:	787-723-4177

Provider Business Practice Location Address
First Line	:	563 CALLE CABO H ALVERIO
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3725
Country	:	US
Telephone Number	:	787-771-3010
Fax Number	:	787-723-4177

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. ROBERT KUTCHER
Credential	:	M.D.
Telephone Number	:	787-771-3010

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	10/24/2013

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