Provider Demographics
NPI:1699975441
Name:ASOCIACION PUERTORRIQUENA DEL PULMON
Entity type:Organization
Organization Name:ASOCIACION PUERTORRIQUENA DEL PULMON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SERVICES COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALBA
Authorized Official - Middle Name:
Authorized Official - Last Name:FABRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-5664
Mailing Address - Street 1:PO BOX 195247
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-5247
Mailing Address - Country:US
Mailing Address - Phone:787-765-5664
Mailing Address - Fax:
Practice Address - Street 1:395 CALLE MANUEL DOMENECH
Practice Address - Street 2:HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3717
Practice Address - Country:US
Practice Address - Phone:787-765-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center