Basic Information
| Provider Information | |||||||||
| NPI: | 1417328717 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DR. JOSE R ARROYO MATOS CSP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1077 | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007051077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877354887 | ||||||||
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| Practice Location | |||||||||
| Address1: | 156 CALLE BALDORIOTY N | ||||||||
| Address2: | |||||||||
| City: | AIBONITO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007053218 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877354887 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2015 | ||||||||
| LastUpdateDate: | 10/13/2015 | ||||||||
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| AuthorizedOfficialLastName: | ARROYO | ||||||||
| AuthorizedOfficialFirstName: | JOSE | ||||||||
| AuthorizedOfficialMiddleName: | RAMON | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7877354887 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0901X | 8196 | PR | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Public Health & General Preventive Medicine | 208D00000X | 8196 | PR | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 2083X0100X | 8196 | PR | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.