Provider Demographics
NPI:1467992396
Name:SERVICIOS NEONATALES DEL ESTE CSP
Entity Type:Organization
Organization Name:SERVICIOS NEONATALES DEL ESTE CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-612-0813
Mailing Address - Street 1:PO BOX 8940
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8940
Mailing Address - Country:US
Mailing Address - Phone:787-612-0813
Mailing Address - Fax:
Practice Address - Street 1:111 CALLE 1
Practice Address - Street 2:PASEO LAS VISTAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-5943
Practice Address - Country:US
Practice Address - Phone:787-612-0813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-25
Last Update Date:2017-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty