Healthcare Provider Details
I. General information
NPI: 1962556159
Provider Name (Legal Business Name): CENTRO MEDICINA FAMILIAR
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARRETERA 152 KM 12 6 BARRIO CEDRO ARRIBA
NARANJITO PR
00719
US
IV. Provider business mailing address
U11 CALLE LEILA ESTE
LEVITTOWN PR
00949-4618
US
V. Phone/Fax
- Phone: 787-869-9336
- Fax:
- Phone: 787-869-8708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | PR |
VIII. Authorized Official
Name: DR.
LILLIAM
M
GUILBEE
Title or Position: MEDICO
Credential:
Phone: 787-869-8708