Provider Demographics
NPI:1184755472
Name:AUDIOLOGY CLINICS OF PUERTO RICO, CSP
Entity type:Organization
Organization Name:AUDIOLOGY CLINICS OF PUERTO RICO, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOWALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:787-844-8595
Mailing Address - Street 1:2225 PONCE BYP STE 406
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-1322
Mailing Address - Country:US
Mailing Address - Phone:787-844-8595
Mailing Address - Fax:787-848-8179
Practice Address - Street 1:2225 PONCE BYP STE 406
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-844-8595
Practice Address - Fax:787-848-8179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech