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Organization

PROGRAMA CUIDADO INTEGRAL DEL SIDA

Active
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Organization

PROGRAMA CUIDADO INTEGRAL DEL SIDA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOSE R FELICIANO-SEPULVEDA MHSA (EJECUTIVE DIRECTOR)
(787) 852-0768
Entity
Organization

Contact information

Practice address
355 CALLE FONT MARTELO, HUMACAO, PR 00791-3249
(787) 852-0768
(787) 656-0735
Mailing address
PO BOX 859, HUMACAO, PR 00792-0859
(787) 852-0768
(787) 656-0735

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
15F2515
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0436140001
MEDICARE
PR
Enumeration date
07/16/2013
Last updated
07/16/2013
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