Provider Demographics
NPI:1043399264
Name:CDT EULALIA KUILAN REVERON
Entity Type:Organization
Organization Name:CDT EULALIA KUILAN REVERON
Other - Org Name:GOBIERNO MUNICIPAL DE CATANO
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRADOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAXEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDRASA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-788-1970
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-0428
Mailing Address - Country:US
Mailing Address - Phone:787-788-1905
Mailing Address - Fax:787-788-1996
Practice Address - Street 1:CARR. 869 BARRIO PALMAS
Practice Address - Street 2:
Practice Address - City:CATAO
Practice Address - State:PR
Practice Address - Zip Code:00963
Practice Address - Country:US
Practice Address - Phone:787-788-1949
Practice Address - Fax:787-275-0430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17048282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital