Healthcare Provider Details

I. General information

NPI: 1568379394
Provider Name (Legal Business Name): MED CENTRO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RD 153, KM 13.7 SAN ILDEFONSO WARD
COAMO PR
00769
US

IV. Provider business mailing address

PO BOX 220
MERCEDITA PR
00715-0220
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-9393
  • Fax: 939-214-4095
Mailing address:
  • Phone: 787-843-9393
  • Fax: 939-214-4095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ALLAN CINTRON
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, MHCM
Phone: 787-843-9393