Provider Demographics
NPI:1164766697
Name:HYPERBARICS AND WOUND CARE CENTERS OF PUERTO RICO
Entity Type:Organization
Organization Name:HYPERBARICS AND WOUND CARE CENTERS OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-601-4612
Mailing Address - Street 1:15 CALLE LUIS F. DESSUS
Mailing Address - Street 2:
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-601-4612
Mailing Address - Fax:
Practice Address - Street 1:15 CALLE LUIS F. DESSUS
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-601-4612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14191261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty