| Organization Name: | NESC22CSP,SERVICIOSMEDICOS |
| NPI Number: | 1093092298 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NELSON E SANTIAGO (PRESIDENT) |
| Mailing Address: | Urb. Montemar No. 112 Urb. Montemar No. 112 Aguada |
| State: | PR US |
| Postal Code: | 00602 |
| Phone Number: | 7875603350 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2011 |
| NPI Last Update Date: | 11/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QH0100X |
| License Number: | 11251 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Health Service |
| Taxonomy Definition: | |