Healthcare Provider Details

I. General information

NPI: 1427383793
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 3 KM 8.3 AVE. 65 DE INFANTERIA
CAROLINA PR
00984
US

IV. Provider business mailing address

PO BOX 29207
SAN JUAN PR
00929-0207
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-6330
  • Fax: 787-757-0520
Mailing address:
  • Phone: 787-757-6330
  • Fax: 787-757-0520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MYRIAM TROCHE
Title or Position: CREDENTIALING COORDINATOR
Credential: RHIA
Phone: 787-758-2525