Provider Demographics
NPI:1841333747
Name:CBF PEDIATRICS CSP
Entity type:Organization
Organization Name:CBF PEDIATRICS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-717-9279
Mailing Address - Street 1:43 PLAZA SUR
Mailing Address - Street 2:ALTAVILLA, ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6096
Mailing Address - Country:US
Mailing Address - Phone:787-717-9279
Mailing Address - Fax:
Practice Address - Street 1:43 PLAZA SUR
Practice Address - Street 2:ALTAVILLA, ENCANTADA
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6096
Practice Address - Country:US
Practice Address - Phone:787-717-9279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1649240813OtherNPI
PR$$$$$$$$$OtherSOCIAL SECURITY