Healthcare Provider Details

I. General information

NPI: 1912172602
Provider Name (Legal Business Name): PCR INTERNAL MEDICINE P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EXTENCION FOREST HILLS E 55 CALLE MARGINAL
BAYAMON PR
00959
US

IV. Provider business mailing address

URBANIZACION SANTA JUANITA PMB 206 UU 1 CALLE 39
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-779-8311
  • Fax: 787-779-8311
Mailing address:
  • Phone: 787-779-8311
  • Fax: 787-779-8311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number11842
License Number StatePR

VIII. Authorized Official

Name: DR. PILAR CABRERA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-779-8311