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NPI Code Detail

MEDICARE: CLINICA DE CUIDADO MEDICO, INC.

MEDICARE: CLINICA DE CUIDADO MEDICO, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center84PR

General Provider Information

NPI Number : 1275567455
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLINICA DE CUIDADO MEDICO, INC.
Provider Business Mailing Address
First Line : PO BOX 1347
Second Line :
City : CIALES
State : PR
Zip : 00638-1347
Country : US
Telephone Number : 787-871-0587
Fax Number :
Provider Business Practice Location Address
First Line : 4 CALLE HOSPITAL
Second Line :
City : CIALES
State : PR
Zip : 00638-3310
Country : US
Telephone Number : 787-871-1098
Fax Number :
Authorized Official
Title or Position : PRESIDENTE
Name : DR. JORGE D. JIMENEZ
Credential : MD
Telephone Number : 787-871-1098
Provider Enumeration Date : 07/11/2006
Last Update Date : 12/30/2013

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