Provider Demographics
NPI:1013193440
Name:OUTPATIENT ALTERNATIVES
Entity Type:Organization
Organization Name:OUTPATIENT ALTERNATIVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/ VICE-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-831-0266
Mailing Address - Street 1:MAYGUEZ MALL
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-1251
Mailing Address - Country:US
Mailing Address - Phone:787-832-0653
Mailing Address - Fax:
Practice Address - Street 1:15 CALLE LUIS FELIPE DEJESUS
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-1501
Practice Address - Country:US
Practice Address - Phone:787-832-0653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14191261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR22237OtherMEDICARE PROVIDER NUMBER