# NEFROLOGIA CSP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NEFROLOGIA CSP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588048482
- **Authorized official:** DR. MANUEL A CRUZ SOTO M.D. (PRESIDENT)
- **Authorized official phone:** (787) 854-4120

## Contact information

- **Practice address:** AVE HERNANDEZ CARRION, MANATI PROFESSIONAL PLAZA SUITE 411, MANATI, PR 00674-1662
- **Practice address phone:** (787) 854-4120
- **Practice address fax:** (787) 621-0907
- **Mailing address:** PO BOX 1662, MANATI, PR 00674-1662
- **Mailing address phone:** (787) 854-4120
- **Mailing address fax:** (787) 621-0907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 5004 | PR | Yes |

## Other

- **Enumeration date:** 07/10/2015
- **Last updated:** 07/10/2015