Organization
POLICLINICA FAMILIAR SHALOM INC
Active
Organization
POLICLINICA FAMILIAR SHALOM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN FELICIANO (SUPERVISOR)
(787) 291-0991
Entity
Organization
Contact information
Practice address
BO TERRANOVA CALLE MARGINAL DEL PARQUE, QUEBRADILLAS, PR 00678
(787) 895-0914
Mailing address
PO BOX 903, QUEBRADILLAS, PR 00678-0903
(787) 895-0914
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
145
—
208D00000X
General Practice Physician
11789
PR
Other
Enumeration date
05/07/2007
Last updated
07/06/2017
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