Provider Demographics
NPI:1972704195
Name:CFSE
Entity type:Organization
Organization Name:CFSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-246-4176
Mailing Address - Street 1:PO BOX 14522
Mailing Address - Street 2:BO OBRERO STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CFSE CARR #3, AVE. 65 INFANTERIA INTERSECCION CARR 887
Practice Address - Street 2:BO. SAN ANTON
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00986-0858
Practice Address - Country:US
Practice Address - Phone:787-757-6850
Practice Address - Fax:787-776-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13147207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13147OtherSTATE MEDICAL LICENSE NUM
PR13147OtherSTATE MEDICAL LICENSE NUM