Provider Demographics
NPI:1013103753
Name:QUIMIO AMBULATORIA DR. CARLOS DEL VALLE
Entity Type:Organization
Organization Name:QUIMIO AMBULATORIA DR. CARLOS DEL VALLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-833-4585
Mailing Address - Street 1:14 CALLE PERAL N
Mailing Address - Street 2:COND. LA PALMA 1-H
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4861
Mailing Address - Country:US
Mailing Address - Phone:787-833-4585
Mailing Address - Fax:787-831-1366
Practice Address - Street 1:14 CALLE PERAL N
Practice Address - Street 2:COND. LA PALMA 1-H
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4861
Practice Address - Country:US
Practice Address - Phone:787-833-4585
Practice Address - Fax:787-831-1366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3454261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology