Provider Demographics
NPI:1790035616
Name:CLINICA FAMILIAR COTO LAUREL INC
Entity Type:Organization
Organization Name:CLINICA FAMILIAR COTO LAUREL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS VAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-848-1005
Mailing Address - Street 1:PO BOX 800383
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0383
Mailing Address - Country:US
Mailing Address - Phone:787-848-1005
Mailing Address - Fax:787-840-8269
Practice Address - Street 1:CALLE DEL PARQUE
Practice Address - Street 2:BLOQUE 1 SUITE 1
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-848-1005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty