Healthcare Provider Details

I. General information

NPI: 1386613446
Provider Name (Legal Business Name): POLICLINICA LAS AMERICAS MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 04/14/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 BLVD LUIS A FERRE STE 101
PONCE PR
00717-0798
US

IV. Provider business mailing address

PMB 281 AVE MUNOZ RIVERA 1575
PONCE PR
00717-0211
US

V. Phone/Fax

Practice location:
  • Phone: 787-842-8945
  • Fax: 787-290-4472
Mailing address:
  • Phone: 787-842-8945
  • Fax: 787-290-4472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VICTOR S REYES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 787-842-8945