Healthcare Provider Details

I. General information

NPI: 1215312368
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 3 KM 8.3 AVE 65 DE INFANTERIA HOSPITAL DE LA UPR DR. FEDERICO TRILLA
CAROLINA PR
00984
US

IV. Provider business mailing address

PO BOX 29207 HEMATOLOGIA Y ONCOLOGIA HUPR
SAN JUAN PR
00929-0207
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax: 787-757-0520
Mailing address:
  • Phone: 787-757-6420
  • Fax: 787-757-0520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: MS. SHAYRA C. MORALES
Title or Position: ADMINISTRATIVE SECRETARY
Credential:
Phone: 787-754-9165