Provider Demographics
NPI:1891063616
Name:ACO DEL NORTE PPN, LLC
Entity Type:Organization
Organization Name:ACO DEL NORTE PPN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR EJECUTIVO
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:LCDO
Authorized Official - Phone:787-817-3144
Mailing Address - Street 1:PO BOX 9920
Mailing Address - Street 2:COTTO STATION
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9920
Mailing Address - Country:US
Mailing Address - Phone:787-817-3144
Mailing Address - Fax:787-879-4315
Practice Address - Street 1:CALLE 16 V-1
Practice Address - Street 2:URB. VILLA LOS SANTOS
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-817-3144
Practice Address - Fax:787-879-4315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty