Provider Demographics
NPI:1275206872
Name:DERMWATTS
Entity Type:Organization
Organization Name:DERMWATTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:T
Authorized Official - Last Name:WATTS OQUENDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-455-7822
Mailing Address - Street 1:1302 AVE ASHFORD APT 2102
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1368
Mailing Address - Country:US
Mailing Address - Phone:787-455-7822
Mailing Address - Fax:
Practice Address - Street 1:C8 AVE. GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MALL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-772-9850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty