Organization Name: | PONCE MEDICAL SCHOOL FOUNDATION |
NPI Number: | 1285648279 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HECTOR BURGOS (OPERATIONS MANAGER) |
Mailing Address: | Nieves Pettite Mall Local # 2 Guayama |
State: | PR US |
Postal Code: | 00785 |
Phone Number: | 7878662726 |
Fax Number: | 7878660014 |
NPI Enumeration Date: | 07/28/2006 |
NPI Last Update Date: | 08/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |