Provider Demographics
NPI:1780830760
Name:CORP. SERVICIOS ANA DE LLAVES
Entity Type:Organization
Organization Name:CORP. SERVICIOS ANA DE LLAVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:I
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-292-1020
Mailing Address - Street 1:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00977-0892
Mailing Address - Country:US
Mailing Address - Phone:787-292-1020
Mailing Address - Fax:787-292-1211
Practice Address - Street 1:CARR 181 KM 2.2
Practice Address - Street 2:BP LAS CUEVAS
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-292-1020
Practice Address - Fax:787-292-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherACAA