Organization · NPI-2

Otologic Psc

Otolaryngology, Otology & Neurotology · Mayaguez, PR

NPI number1417095944
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1417095944
Entity type
Organization (NPI-2)
Legal business name
Otologic Psc
Organization subpart
No
Enumeration date
Feb 5, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207YX0901X Otolaryngology, Otology & Neurotology11064PRYes

Practice location

55e De Diego St.
Suite 105, Cpr Professional Bldg.
Mayaguez, PR 00680

Phone 787-833-2155 · Fax 787-833-2680

Mailing address

Po Box 6428
Mayaguez, PR 00781-6428

Phone 787-833-2155 · Fax 787-833-2680

Authorized official

Miguel A. Lasalle
Dueno
7878332155

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