MEDICARE: CENTRO MEDICO DEL TURABO 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
1	2081P0010X	Pediatric Rehabilitation Medicine Physician

General Provider Information

NPI Number	:	1922233378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO MEDICO DEL TURABO INC

Provider Business Mailing Address
First Line	:	PO BOX 4980
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-4980
Country	:	US
Telephone Number	:	787-653-3434
Fax Number	:	787-653-1296

Provider Business Practice Location Address
First Line	:	AVE LUIS MUNOZ MARIN #100
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-653-3434
Fax Number	:	787-653-1296

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. ORLANDO RIVERA
Credential	:	LCDO
Telephone Number	:	787-653-3434

Provider Enumeration Date	:	05/28/2009
Last Update Date	:	09/11/2013

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