Provider Demographics
NPI:1851605547
Name:NAVAL HOSPITAL ROTA SPAIN
Entity Type:Organization
Organization Name:NAVAL HOSPITAL ROTA SPAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:LESSER
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:669126-430-3534
Mailing Address - Street 1:PSC 807
Mailing Address - Street 2:BOX 33
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09729-0002
Mailing Address - Country:US
Mailing Address - Phone:35191-345-1230
Mailing Address - Fax:
Practice Address - Street 1:PSC 819
Practice Address - Street 2:BOX 18 - 211
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09645-9998
Practice Address - Country:US
Practice Address - Phone:639103-997-3681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty CorpsmanGroup - Single Specialty