Organization Name: | DR. EDGAR O. CARO CRUZ |
NPI Number: | 1003276148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDGAR O CARO CRUZ (PRESIDENT) |
Mailing Address: | 2 Calle Benito Feijoo Urbanizacion Villas Del Este San Juan |
State: | PR US |
Postal Code: | 00926 |
Phone Number: | 7873700310 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2016 |
NPI Last Update Date: | 03/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | 989 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |