Organization
SALUD DIRECTA DE PUERTO RICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILDALIAS DOMIGUEZ PASCUAL M.D. (PRESIDENT)
(787) 883-0124
Entity
Organization
Contact information
Practice address
CALLE LUIS MUNOZ RIVERA #3, VEGA ALTA, PR 00692
(787) 883-0124
(787) 883-0222
Mailing address
PO BOX 4317, VEGA BAJA, PR 00694-4317
(787) 883-0124
(787) 883-0222
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
PR
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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