Provider Demographics
NPI:1346834355
Name:VILLA TOLEDO CENTRO DE REHABILITACION E IMPLANTOLOGIA ORAL
Entity Type:Organization
Organization Name:VILLA TOLEDO CENTRO DE REHABILITACION E IMPLANTOLOGIA ORAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-241-3634
Mailing Address - Street 1:PO BOX 140068
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-0068
Mailing Address - Country:US
Mailing Address - Phone:787-241-3634
Mailing Address - Fax:
Practice Address - Street 1:BO HATO ARRIBA CARR 129 KM 5-2 BLDG
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-816-1041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental