Organization Name: | IPA MUNICIPAL TOA ALTA 357 |
NPI Number: | 1033414966 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RODRIGUEZ BENITEZ JOSE (PRESIDENT) |
Mailing Address: | Calle Barcelo 16 Toa Alta |
State: | PR US |
Postal Code: | 009530000 |
Phone Number: | 7877450708 |
Fax Number: | 7877479300 |
NPI Enumeration Date: | 01/25/2011 |
NPI Last Update Date: | 01/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |