Organization
BIDOT PREVENTIVE MEDICINE CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAYRA D BIDOT MD (DIRECTOR)
(787) 265-4610
Entity
Organization
Contact information
Practice address
67 CALLE EDUARDO RIERA, MAYAGUEZ, PR 00680-3811
(787) 265-4610
Mailing address
67 CALLE EDUARDO RIERA, MAYAGUEZ, PR 00680-3811
(787) 265-4610
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
9542
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9542
STATE LICENCE
PR
Enumeration date
10/16/2006
Last updated
08/17/2023
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