Organization
CDT DE TOA ALTA PUEBLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLEMENTE AGOSTO LUGARDO (MAJOR)
(787) 870-2100
Entity
Organization
Contact information
Practice address
16 CALLE BARCELO, TOA ALTA, PR 00953-2444
(787) 870-8690
(787) 870-2600
Mailing address
PO BOX 1649, CANOVANAS, PR 00729-1649
(787) 870-2100
(787) 876-2422
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609917848
—
PR
Enumeration date
05/21/2013
Last updated
05/21/2013
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