# CLINICA ESPANOLA INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINICA ESPANOLA INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598820540
- **Authorized official:** EMIGOLIO AGOSTINI (ADMIN PRES JUNTA DE GOBIERNO)
- **Authorized official phone:** (787) 832-0404

## Contact information

- **Practice address:** BARRIO BALBOA SECTOR LA QUINTA CARR 106, MAYAGUEZ, PR 00680
- **Practice address phone:** (787) 832-0404
- **Practice address fax:** (787) 831-0034
- **Mailing address:** PO BOX 490, MAYAGUEZ, PR 00681-0490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 13F-1043 | PR | Yes |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 05/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4025498 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |