Provider Demographics
NPI:1407195373
Name:FUNDACION DE INVESTIGACION DE DIEGO
Entity Type:Organization
Organization Name:FUNDACION DE INVESTIGACION DE DIEGO
Other - Org Name:FUNDACION DE INVESTIGACION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:RODRIGUEZ-ORENGO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-722-1248
Mailing Address - Street 1:998 AVE MUNOZ RIVERA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4308
Mailing Address - Country:US
Mailing Address - Phone:787-722-1248
Mailing Address - Fax:787-721-6098
Practice Address - Street 1:998 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-4308
Practice Address - Country:US
Practice Address - Phone:787-722-1248
Practice Address - Fax:787-721-6098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QC1500X, 261QM2500X, 261QR1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch