Provider Demographics
NPI:1487929477
Name:NORTH SHORE EMERGENCY LLC
Entity type:Organization
Organization Name:NORTH SHORE EMERGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROCAFORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-215-2300
Mailing Address - Street 1:997 CALLE ACAPULCO
Mailing Address - Street 2:RESIDENCIA VISTA MAR
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-5654
Mailing Address - Country:US
Mailing Address - Phone:787-215-2300
Mailing Address - Fax:
Practice Address - Street 1:550 CALLE CONCEPCION VERA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-5005
Practice Address - Country:US
Practice Address - Phone:787-877-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13397207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty