Organization
PR RENAL HEALTH AND RESEARCH INC
Active
Organization
PR RENAL HEALTH AND RESEARCH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OTEGBOLA OJO M.D. (PRESIDENT AND CEO)
(787) 710-2532
Entity
Organization
Contact information
Practice address
600 COMERIO AVE, 2ND FLOOR, TOA BAJA, PR 00949-2821
(787) 710-2532
(939) 202-7294
Mailing address
PO BOX 51502, TOA BAJA, PR 00950-1502
(787) 710-2532
(939) 202-7294
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EC848A
MEDICARE PTAN
PR
Enumeration date
02/10/2015
Last updated
02/10/2015
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