Provider Demographics
NPI:1770703845
Name:DEPARTAMENTO DE SALUD OFICIAL
Entity type:Organization
Organization Name:DEPARTAMENTO DE SALUD OFICIAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA MEDICA
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETZAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-741-2165
Mailing Address - Street 1:P O BOX 326
Mailing Address - Street 2:
Mailing Address - City:VIEQUES
Mailing Address - State:PR
Mailing Address - Zip Code:00765
Mailing Address - Country:US
Mailing Address - Phone:787-741-0392
Mailing Address - Fax:787-741-0398
Practice Address - Street 1:CARR 997 KM 0 HM 1
Practice Address - Street 2:BO DESTINO
Practice Address - City:VIEQUES
Practice Address - State:PR
Practice Address - Zip Code:00765
Practice Address - Country:US
Practice Address - Phone:787-741-0392
Practice Address - Fax:787-741-0398
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTAMENTO DE SALUD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-30
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR00377OtherHOSPITAL
PR19087OtherHOSPITAL
PR19780OtherHOSPITAL
PR660433481OtherHOSPITAL
PR660436342VOtherHOSPITAL
PR030736OtherHOSPITAL
PR40156OtherHOSPITAL
PRS904OtherHOSPITAL
PRSH00630OtherHOSPITAL
PR600221OtherHOSPITAL
PR09722OtherHOSPITAL
PR1000179OtherHOSPITAL
PR660433481VOtherHOSPITAL
PR7650010OtherHOSPITAL
PR40156OtherHOSPITAL
PR660436342VOtherHOSPITAL