Healthcare Provider Details

I. General information

NPI: 1235756339
Provider Name (Legal Business Name): INTEGRATE COMMUNITY HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR # 3, KM 43.8 BO. QUEBRADA FAJARDO
FAJARDO PR
00738
US

IV. Provider business mailing address

400 CALLE CALAF PMB 455
SAN JAUN PR
00918-1314
US

V. Phone/Fax

Practice location:
  • Phone: 787-710-9867
  • Fax:
Mailing address:
  • Phone: 787-370-6648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA LOPEZ
Title or Position: VP SENIOR
Credential:
Phone: 787-230-7530