Healthcare Provider Details

I. General information

NPI: 1801816400
Provider Name (Legal Business Name): CENTRO DE SALUD INTEGRAL CAGUAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LUIS MUNOZ MARIN AVE R-1 URB. MARIOLGA
CAGUAS PR
00726
US

IV. Provider business mailing address

PO BOX 836
CAGUAS PR
00726-0836
US

V. Phone/Fax

Practice location:
  • Phone: 787-744-0208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DIEGO VARGAS GONZALEZ
Title or Position: PRESIDENTE
Credential:
Phone: 787-747-0022