Healthcare Provider Details

I. General information

NPI: 1124932686
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 AVE 65 INFANTERIA
CAROLINA PR
00985-5575
US

IV. Provider business mailing address

PO BOX 29207
SAN JUAN PR
00929-0207
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 787-758-2525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: WILMA RODRIGUEZ
Title or Position: BILLING DIRECTOR
Credential:
Phone: 787-758-2525