Provider Demographics
NPI:1245264845
Name:POLICLINICA SALUD DEL NORTE INC.
Entity type:Organization
Organization Name:POLICLINICA SALUD DEL NORTE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:VARGAS JIMENEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-855-4012
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-0047
Mailing Address - Country:US
Mailing Address - Phone:787-855-4012
Mailing Address - Fax:787-855-4014
Practice Address - Street 1:CARR.687 KM.0.1
Practice Address - Street 2:BO. ALGARROBO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-4012
Practice Address - Fax:787-855-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty