Provider Demographics
NPI:1114178993
Name:CORPORACION COAMENA DE LA SALUD
Entity Type:Organization
Organization Name:CORPORACION COAMENA DE LA SALUD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-825-4558
Mailing Address - Street 1:PO BOX 2290
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-4290
Mailing Address - Country:US
Mailing Address - Phone:787-825-4558
Mailing Address - Fax:787-825-6422
Practice Address - Street 1:20 CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-2411
Practice Address - Country:US
Practice Address - Phone:787-825-4558
Practice Address - Fax:787-825-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10535174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty