Provider Demographics
NPI:1679227003
Name:TOA BAJA MEDICAL PLAZA INC
Entity Type:Organization
Organization Name:TOA BAJA MEDICAL PLAZA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARLING
Authorized Official - Middle Name:T
Authorized Official - Last Name:PANTOJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-306-1900
Mailing Address - Street 1:PMB 164 PO BOX 4002
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692
Mailing Address - Country:US
Mailing Address - Phone:787-306-1900
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA #2 KM 18.4 BO. CANDELARIA AREN
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00951-0001
Practice Address - Country:US
Practice Address - Phone:787-979-9189
Practice Address - Fax:787-979-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service