| Club Del Desarrollo Integral, Psc | |
|
110 Calle Carazo Guaynabo PR 00969-5717 | |
| (787) 790-1583 | |
| Not Available |
| Full Name | Club Del Desarrollo Integral, Psc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 110 Calle Carazo, Guaynabo, Puerto Rico |
| Authorized Official Name and Position | Raul Rivera Vega (PRESIDENT) |
| Authorized Official Contact | 7877901583 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Club Del Desarrollo Integral, Psc 110 Calle Carazo Guaynabo PR 00969-5717 Ph: (787) 790-1583 | Club Del Desarrollo Integral, Psc 110 Calle Carazo Guaynabo PR 00969-5717 Ph: (787) 790-1583 |
| NPI Number | 1134650880 |
|---|---|
| Provider Enumeration Date | 03/24/2017 |
| Last Update Date | 03/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134650880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 1008 (Puerto Rico) | Primary |
| 261QP2000X | Clinic/center - Physical Therapy | 1361 (Puerto Rico) | Secondary |
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