Healthcare Provider Details

I. General information

NPI: 1093544132
Provider Name (Legal Business Name): CENTRO DE SALUD DE LARES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 111 KM 1.9 AVE. LOS PATRIOTAS
LARES PR
00669-0379
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 Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAMARIS RODRIGUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 787-897-2727