Organization
ALD NEPHROLOGY PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO DIAZ HERNANDEZ MD (PRESIDENT)
(787) 726-7008
Entity
Organization
Contact information
Practice address
611 CALLE PAVIA, OFIC 214, SAN JUAN, PR 00909-2239
(787) 726-7008
(787) 726-7083
Mailing address
ESTANCIAS DEL BLVD, 143, SAN JUAN, PR 00926-9570
(787) 726-7008
(787) 726-7083
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17173
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17173
LICENCIA
PR
Enumeration date
02/16/2012
Last updated
02/16/2012
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