| NPI | 1629485073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA M ALVAREZ Hub Administrator 787-887-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: PR 10759) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |