Healthcare Provider Details

I. General information

NPI: 1295038768
Provider Name (Legal Business Name): COMMUNITY HEALTH EDUCATION AND MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO QUEBRADAS CARR 377 KM1.5
GUAYANILLA PR
00656-0366
US

IV. Provider business mailing address

BO QUEBRADAS PO BOX 560366
GUAYANILLA PR
00656-0366
US

V. Phone/Fax

Practice location:
  • Phone: 787-219-9293
  • Fax:
Mailing address:
  • Phone: 787-219-9293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6410
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number6410
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6410
License Number StatePR

VIII. Authorized Official

Name: DR. JOSE R PEREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-219-9293