Provider Demographics
NPI:1851495220
Name:CENTRO NEUMOLOGICO DEL ESTE CSP
Entity Type:Organization
Organization Name:CENTRO NEUMOLOGICO DEL ESTE CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-860-4224
Mailing Address - Street 1:PO BOX 13543
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-3543
Mailing Address - Country:US
Mailing Address - Phone:787-860-4224
Mailing Address - Fax:787-860-4224
Practice Address - Street 1:AV. GENERAL VALERO KM. 2.6 CARR.194 EDIFICIO 404
Practice Address - Street 2:
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-4224
Practice Address - Fax:787-860-4224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty