Healthcare Provider Details

I. General information

NPI: 1336286400
Provider Name (Legal Business Name): MIGRANT HEALTH CENTER WESTERN REGION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 03/20/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOLAR REMANENTE # 497 CALLE RAMON E. BETANCES
MAYAGUEZ PR
00680-1714
US

IV. Provider business mailing address

PO BOX 190
MAYAGUEZ PR
00681-0190
US

V. Phone/Fax

Practice location:
  • Phone: 787-805-2900
  • Fax: 787-834-1924
Mailing address:
  • Phone: 787-805-2900
  • Fax: 787-834-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number07F0890
License Number StatePR

VIII. Authorized Official

Name: DR. TANIA RODRIGUEZ MORALES
Title or Position: DIRECTOR EJECUTIVO
Credential: DRA
Phone: 787-831-5800