Healthcare Provider Details

I. General information

NPI: 1144136045
Provider Name (Legal Business Name): CENTRO DE SALUD DE LARES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 AVE JUAN HERNANDEZ ORTIZ LOCAL COMERCIAL PRIMER NIVEL LA ISABELA SHOPPING CENTER
ISABELA PR
00662-9998
US

IV. Provider business mailing address

PO BOX 379
LARES PR
00669-0379
US

V. Phone/Fax

Practice location:
  • Phone: 787-897-2727
  • Fax: 787-897-2725
Mailing address:
  • Phone: 787-897-2727
  • Fax: 787-897-2725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GLORINIC GONZALEZ
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 787-897-2727