Provider Demographics
NPI:1699118562
Name:PRO SALUD CARE PSC
Entity type:Organization
Organization Name:PRO SALUD CARE PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ DE LASALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-609-6573
Mailing Address - Street 1:PO BOX 886
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0886
Mailing Address - Country:US
Mailing Address - Phone:787-609-6573
Mailing Address - Fax:787-609-6574
Practice Address - Street 1:99 CALLE CORCHADO JUARBE
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-609-6573
Practice Address - Fax:787-609-6574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15434261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center