# CAPITOL CLINICAL COMPREHENSIVE LLC

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

## Provider details

- **NPI number:** 1497274286
- **Authorized official:** MIGUEL A PORTILLA RODRIGUEZ LCDO (PRESIDENTE)
- **Authorized official phone:** (787) 727-1700

## Contact information

- **Practice address:** 703 CALLE VICTOR LOPEZ, SAN JUAN, PR 00909-2843
- **Practice address phone:** (787) 727-1700
- **Practice address fax:** (787) 727-1700
- **Mailing address:** PO BOX 8389, SAN JUAN, PR 00910-0389
- **Mailing address phone:** (787) 727-1700
- **Mailing address fax:** (787) 982-0152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/13/2017
- **Last updated:** 09/13/2017