Healthcare Provider Details

I. General information

NPI: 1144323395
Provider Name (Legal Business Name): ARECIBO HEALTHCARE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 CALLE GAUTIER BENITEZ
ARECIBO PR
00612-4418
US

IV. Provider business mailing address

PO BOX 846
ARECIBO PR
00613-0846
US

V. Phone/Fax

Practice location:
  • Phone: 787-880-1020
  • Fax: 787-880-1011
Mailing address:
  • Phone: 787-880-1020
  • Fax: 787-880-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CLARA MOLINA ADAME
Title or Position: MD
Credential:
Phone: 787-880-1020