Healthcare Provider Details

I. General information

NPI: 1003730490
Provider Name (Legal Business Name): CENTRO MED EXPERIENCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PR 805 KM 3.5 BO NEGRO PR 00783
COROZAL PR
00783
US

IV. Provider business mailing address

B8 CALLE ROSA
BAYAMON PR
00959-4148
US

V. Phone/Fax

Practice location:
  • Phone: 787-394-4240
  • Fax:
Mailing address:
  • Phone: 787-394-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE LOPEZ
Title or Position: CEO
Credential: MBA
Phone: 787-394-4240