Star Kids Club-Cbs Prediatric
Exclusive Provider Organization in Guaynabo, PR. Organization (NPI-2).
NPI number1457633448
StatusActive
Last updated in NPPESSep 15, 2011
Details
- NPI
- 1457633448
- Entity type
- Organization (NPI-2)
- Legal business name
- Star Kids Club-Cbs Prediatric
- Organization subpart
- No
- Enumeration date
- Sep 15, 2011
- Last updated
- Sep 15, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | 1128 | PR | Yes |
Practice location
101 Ave San PatricioMaramar Plaza
Guaynabo, PR 00968-2645
Phone 787-474-0400
Mailing address
101 Ave San PatricioMaramar Plaza
Guaynabo, PR 00968-2645
Phone 787-474-0400
Authorized official
Carmen Franceschi
President
7879469693
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