Organization Name: | RENOVA CORP. CSP |
NPI Number: | 1043679236 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANICE MARIE RODRIGUEZ (MEDICAL DIRECTOR) |
Mailing Address: | Carr 2 Km 141.1 Ave Severeano Cuevas #18 Western Medical Plaza 1st Floor Suite # 24 Aguadilla |
State: | PR US |
Postal Code: | 00605 |
Phone Number: | 7874127009 |
Fax Number: | 7879190644 |
NPI Enumeration Date: | 02/16/2016 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2500X |
License Number: | 17029 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Medical Specialty |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |