Organization
CLINICA GERIATRIA Y ORTOPEDIA DEL OESTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN L PORTALATIN MD (PRESIDENT/CEO)
(787) 710-5835
Entity
Organization
Contact information
Practice address
CARR #2 BO KM 119.2 BO CAIMITAL ALTO, AGUADILLA, PR 00603
(787) 710-5835
Mailing address
PO BOX 4808, AGUADILLA, PR 00605-4808
(787) 710-5835
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/31/2024
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