| Organization Name: | CDT DE TOA ALTA PUEBLO |
| NPI Number: | 1093151631 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLEMENTE AGOSTO LUGARDO (MAJOR) |
| Mailing Address: | 16 Calle Barcelo Toa Alta |
| State: | PR US |
| Postal Code: | 009532444 |
| Phone Number: | 7878708690 |
| Fax Number: | 7878702600 |
| NPI Enumeration Date: | 05/21/2013 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0002X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Emergency Care |
| Taxonomy Definition: | |