Healthcare Provider Details

I. General information

NPI: 1568594703
Provider Name (Legal Business Name): CENTRO DE SALUD FAMILIAR OROCOVIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARRETERA 155 AVE LUIS MUNOZ MARIN SECTOR EL DESVIO
OROCOVIS PR
00720
US

IV. Provider business mailing address

PO BOX 372800
CAYEY PR
00737-2800
US

V. Phone/Fax

Practice location:
  • Phone: 787-535-1001
  • Fax:
Mailing address:
  • Phone: 787-434-1700
  • Fax: 787-434-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LISSETTE VAZQUEZ-RIVERA
Title or Position: BILLING MANAGER
Credential:
Phone: 787-434-1700