Provider Demographics
NPI:1831456425
Name:SERVICIOS DE HEMATOLOGIA Y ONCOLOGIA DEL ESTE
Entity type:Organization
Organization Name:SERVICIOS DE HEMATOLOGIA Y ONCOLOGIA DEL ESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:TEJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-801-0505
Mailing Address - Street 1:PO BOX 3374
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3374
Mailing Address - Country:US
Mailing Address - Phone:787-655-4060
Mailing Address - Fax:787-801-0505
Practice Address - Street 1:TORRE SAN PABLO DEL ESTE
Practice Address - Street 2:SUITE 205
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-3988
Practice Address - Country:US
Practice Address - Phone:787-801-0505
Practice Address - Fax:787-801-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13092261QI0500X, 261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy