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Organization
CAPITOL CLINICAL COMPREHENSIVE LLC
Active
Organization
CAPITOL CLINICAL COMPREHENSIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL A PORTILLA RODRIGUEZ LCDO (PRESIDENTE)
(787) 727-1700
Entity
Organization
Contact information
Practice address
703 CALLE VICTOR LOPEZ, SAN JUAN, PR 00909-2843
(787) 727-1700
(787) 727-1700
Mailing address
PO BOX 8389, SAN JUAN, PR 00910-0389
(787) 727-1700
(787) 982-0152
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
NULL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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