# BROKEN BONE ORTHO CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215266564
- **Authorized official:** DR. RAFAEL OTERO MD (PRESIDENT)
- **Authorized official phone:** (787) 756-6999

## Contact information

- **Practice address:** 369 CALLE DE DIEGO STE 202, TORRE SAN FRANCISCO, SAN JUAN, PR 00923-3004
- **Practice address phone:** (787) 756-6999
- **Practice address fax:** (787) 765-7880
- **Mailing address:** PO BOX 366905, SAN JUAN, PR 00936-6905
- **Mailing address phone:** (787) 756-6999
- **Mailing address fax:** (787) 765-7880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 4470 | PR | Yes |

## Other

- **Enumeration date:** 12/16/2009
- **Last updated:** 08/10/2011