Healthcare Provider Details

I. General information

NPI: 1679781579
Provider Name (Legal Business Name): PRICARE MEDICAL SERVICES PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4257 AVE CONSTANCIA VILLA DEL CARMEN
PONCE PR
00716-2117
US

IV. Provider business mailing address

4257 AVE CONSTANCIA VILLA DEL CARMEN
PONCE PR
00716-2117
US

V. Phone/Fax

Practice location:
  • Phone: 787-690-6650
  • Fax: 787-813-1836
Mailing address:
  • Phone: 787-690-6650
  • Fax: 787-813-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number14424
License Number StatePR

VIII. Authorized Official

Name: DR. JEANNETTE FIGUEROA-GORDIAN
Title or Position: PRESIDENT
Credential: MD
Phone: 787-690-6650