Provider Demographics
NPI:1598985889
Name:DEPARTAMENTO DE SALUD OFICIAL
Entity type:Organization
Organization Name:DEPARTAMENTO DE SALUD OFICIAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARIO AUXILIAR II
Authorized Official - Prefix:
Authorized Official - First Name:YESAREL
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PESANTE SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-2929
Mailing Address - Street 1:PO BOX 70184
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8184
Mailing Address - Country:US
Mailing Address - Phone:787-765-2929
Mailing Address - Fax:787-771-2295
Practice Address - Street 1:CARRT. 188 KM5 HM 6
Practice Address - Street 2:INT. 187
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-876-2245
Practice Address - Fax:787-771-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5365-05261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRSH00154OtherE R
PR10112OtherE R
PR40152OtherE R
PR660436342LOOtherE R
PW19190OtherE R
PR600349OtherE R
PR660433481OtherE R
PR660433481LOOtherE R
PR7720006OtherE R
PRS809OtherE R
PR00431OtherE R
PR1001744OtherE R