Healthcare Provider Details

I. General information

NPI: 1386015162
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR.3 KM 8.3 AVE 65 DE INFANTERIA HOSPITAL UPR FEDERICI TRILLA
CAROLINA PR
00984-0001
US

IV. Provider business mailing address

PO BOX 29207
SAN JUAN PR
00929-0207
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax: 787-757-0520
Mailing address:
  • Phone: 787-758-2525
  • Fax: 787-274-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANA RAMOS
Title or Position: ADMINISTRATIVE ASISTANT
Credential:
Phone: 787-758-2525