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Organization
NCDERM LLC
Active
Organization
NCDERM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SOFIA CARVAJAL DIAZ (PRESIDENT)
(787) 360-6112
Entity
Organization
Contact information
Practice address
500 DEGETAU AVENUE, HIMA PLAZA I, SUITE 513, CAGUAS, PR 00725
(787) 626-3431
(787) 626-5163
Mailing address
1353 AVE LUIS VIGOREAUX, PMB 322, GUAYNABO, PR 00966-2715
(787) 626-3431
(787) 626-5163
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
19082
PR
Other
Enumeration date
08/23/2016
Last updated
09/20/2016
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