| Prosperitus PSC | |
|
400 Carr 176 Apt 605 San Juan PR 00926-6680 | |
| (787) 529-1699 | |
| Not Available |
| Full Name | Prosperitus PSC |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 400 Carr 176 Apt 605, San Juan, Puerto Rico |
| Authorized Official Name and Position | Hiram D Ortega (PRESIDENT) |
| Authorized Official Contact | 7875291699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prosperitus PSC 400 Carr 176 Apt 605 San Juan PR 00926-6680 Ph: (787) 529-1699 | Prosperitus PSC 400 Carr 176 Apt 605 San Juan PR 00926-6680 Ph: (787) 529-1699 |
| NPI Number | 1649525874 |
|---|---|
| Provider Enumeration Date | 07/13/2012 |
| Last Update Date | 07/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649525874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 2903 (Puerto Rico) | Primary |
| 207RG0100X | Internal Medicine - Gastroenterology | 17586 (Puerto Rico) | Secondary |
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