Organization Name: | CLINICA FAMILIAR DR EDWIN OLMEDA CSP |
NPI Number: | 1457416281 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EDWIN OLMEDA (ADMINISTRADOR) |
Mailing Address: | 119 Calle Vidal Felix Hatillo |
State: | PR US |
Postal Code: | 006591818 |
Phone Number: | 7878206182 |
Fax Number: | 7878981993 |
NPI Enumeration Date: | 12/22/2006 |
NPI Last Update Date: | 01/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |