Healthcare Provider Details

I. General information

NPI: 1417027335
Provider Name (Legal Business Name): CENTRO DE SALUD FAMILIAR AGUAS BUENAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUIS MUNOZ RIVERA ST
AGUAS BUENAS PR
00703
US

IV. Provider business mailing address

PO BOX 373130
CAYE PR
00737
US

V. Phone/Fax

Practice location:
  • Phone: 787-535-1001
  • Fax:
Mailing address:
  • Phone: 787-535-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIO COLON
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 787-535-1001