Provider Demographics
NPI:1700116936
Name:INSTITUTO ORTOPEDICO LABORAL, CSP
Entity Type:Organization
Organization Name:INSTITUTO ORTOPEDICO LABORAL, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATIVE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:DE LA CRUZ - ROSSADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-852-6200
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0637
Mailing Address - Country:US
Mailing Address - Phone:787-852-6800
Mailing Address - Fax:787-852-6704
Practice Address - Street 1:269 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3250
Practice Address - Country:US
Practice Address - Phone:787-852-6200
Practice Address - Fax:787-852-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4133261QM2500X, 261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine