Healthcare Provider Details

I. General information

NPI: 1730450313
Provider Name (Legal Business Name): CAYEY PEDIATRICS CENTER P.S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 HERACLIO MENDOZA ST
CAYEY PR
00737-2977
US

IV. Provider business mailing address

PO BOX 372977
CAYEY PR
00737-2977
US

V. Phone/Fax

Practice location:
  • Phone: 787-738-4446
  • Fax: 787-738-4449
Mailing address:
  • Phone: 787-738-4446
  • Fax: 787-738-4449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number6467
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number6467
License Number StatePR

VIII. Authorized Official

Name: DR. JUAN ALBERTO DELGADO RODRIGUEZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-738-4446