Healthcare Provider Details

I. General information

NPI: 1114901592
Provider Name (Legal Business Name): RIN HEALTH CARE SERVICES OF PR INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MCKINLEY 25 WEST ST
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 1236
MAYAGUEZ PR
00681-1236
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-3114
  • Fax: 787-832-3114
Mailing address:
  • Phone: 787-832-3114
  • Fax: 787-832-3114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: MRS. ROSA IVONNE MONTALVO
Title or Position: ADMINISTRATOR
Credential: BS
Phone: 787-832-3114