| Organization Name: | MEDICOS SELECTOS DEL NORTE INC |
| NPI Number: | 1932327665 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MILDALIAS DOMINGUEZ PASCUAL (PRESIDENT) |
| Mailing Address: | Carr #2 Km 31 9 Barrio Bajura Vega Alta |
| State: | PR US |
| Postal Code: | 00692 |
| Phone Number: | 7878830124 |
| Fax Number: | 7878837645 |
| NPI Enumeration Date: | 04/20/2007 |
| NPI Last Update Date: | 07/08/2007 |
| 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: | |