# NORTHEAST CORP

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

## Provider details

- **NPI number:** 1669635397
- **Authorized official:** MRS. JOSE SERRANO LIC (ADMINISTRATOR)
- **Authorized official phone:** (787) 594-6383

## Contact information

- **Practice address:** AVE 1 SANTA RITA, SUITE 304, VEGA ALTA, PR 00692-0000
- **Practice address phone:** (787) 270-1345
- **Practice address fax:** (787) 270-1350
- **Mailing address:** AVE 1 URB SANTA RITA, OFFICE 304, VEGA ALTA, PR 00692-0000
- **Mailing address phone:** (787) 270-1345
- **Mailing address fax:** (787) 270-1350

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 31 | PR | Yes |

## Other

- **Enumeration date:** 07/02/2008
- **Last updated:** 08/26/2008