MEDICARE: CENTRO MEDICO DIAGNOSTICO MUNOZ RIVERA

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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1568168771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO MEDICO DIAGNOSTICO MUNOZ RIVERA

Provider Business Mailing Address
First Line	:	URB MUNOZ RIVERA 59
Second Line	:	AVE ESMERALDA
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-720-3234
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB MUNOZ RIVERA 59
Second Line	:	AVE ESMERALDA
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-720-3234
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JORGE SIGFRIDO MELENDEZ
Credential	:	MD
Telephone Number	:	787-720-3234

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	12/07/2025

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