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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