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Organization
SICK BLOOD MED SERV CSP
Active
Organization
SICK BLOOD MED SERV CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PEDRO G SOLIVAN ORTIZ MD (PRESIDENT)
(787) 771-7933
Entity
Organization
Contact information
Practice address
369 CALLE DE DIEGO STE 603-604, SAN JUAN, PR 00923-3003
(787) 753-6022
(787) 753-6066
Mailing address
369 CALLE DE DIEGO STE 603-604, SAN JUAN, PR 00923-3003
(787) 753-6022
(787) 753-6066
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
17625
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17625
LIC
PR
Enumeration date
03/04/2016
Last updated
01/26/2020
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