Healthcare Provider Details

I. General information

NPI: 1245437946
Provider Name (Legal Business Name): CORRECTIONAL HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 CALLE 1 SUITE 400 METRO OFFICE PARK
GUAYNABO PR
00968-1768
US

IV. Provider business mailing address

PO BOX 859
QUEBRADILLAS PR
00678-0859
US

V. Phone/Fax

Practice location:
  • Phone: 787-774-3344
  • Fax:
Mailing address:
  • Phone: 787-895-5345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number10180
License Number StatePR

VIII. Authorized Official

Name: DR. YANIRA IVONNE PEREZ
Title or Position: CLINICAL SERVICES DIRECTOR
Credential: MD
Phone: 787-774-3344