| Amanecer Mutuo, Psc | |
|
5725 Blvd. Media Luna, Suite # 5 Galerias De Escorial Shopping Center Carolina PR 00987 | |
| (787) 453-0563 | |
| Not Available |
| Full Name | Amanecer Mutuo, Psc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 5725 Blvd. Media Luna, Suite # 5, Carolina, Puerto Rico |
| Authorized Official Name and Position | Jose A Lopez-calero (PRESIDENT) |
| Authorized Official Contact | 7874530563 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanecer Mutuo, Psc Po Box 1893 Carolina PR 00984-1893 Ph: (787) 453-0563 | Amanecer Mutuo, Psc 5725 Blvd. Media Luna, Suite # 5 Galerias De Escorial Shopping Center Carolina PR 00987 Ph: (787) 453-0563 |
| NPI Number | 1801115605 |
|---|---|
| Provider Enumeration Date | 05/19/2010 |
| Last Update Date | 05/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801115605 | NPI | - | NPPES |
| BX187A | Other | PR | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 2751 (Puerto Rico) | Primary |
| 208D00000X | General Practice | 16005 (Puerto Rico) | Secondary |
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› Verified 3 days ago
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