Provider Demographics
NPI:1750445573
Name:CLINICA DE ONCOLOGIA MEDICA T HEMATOLOGICA DEL ESTE
Entity type:Organization
Organization Name:CLINICA DE ONCOLOGIA MEDICA T HEMATOLOGICA DEL ESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-850-6009
Mailing Address - Street 1:263 CALLE FONT MARTELO
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3213
Mailing Address - Country:US
Mailing Address - Phone:787-850-6009
Mailing Address - Fax:787-850-6204
Practice Address - Street 1:263 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3213
Practice Address - Country:US
Practice Address - Phone:787-850-6009
Practice Address - Fax:787-850-6204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG97375Medicare UPIN
PR0090122Medicare ID - Type Unspecified