Healthcare Provider Details

I. General information

NPI: 1740400035
Provider Name (Legal Business Name): DOCTORS CENTER HOSPITAL ARECIBO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. #2 KM 80
ARECIBO PR
00614
US

IV. Provider business mailing address

CARR. #2 KM 80.1
ARECIBO PR
00614
US

V. Phone/Fax

Practice location:
  • Phone: 787-878-0000
  • Fax: 787-878-8106
Mailing address:
  • Phone: 787-878-0000
  • Fax: 787-878-8106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number07B0820
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number708
License Number StatePR

VIII. Authorized Official

Name: MR. PEDRO RIVERA LUGO
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-854-3322