Healthcare Provider Details

I. General information

NPI: 1780888057
Provider Name (Legal Business Name): POLICLINICA MEDICA FAMILIAR DE QUEBRADILLAS, C.S.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR NUM 2 KM 96.8 BO COCOS
QUEBRADILLAS PR
00678
US

IV. Provider business mailing address

CARR NUM 2 6429 PMB 48
QUEBRADILLAS PR
00678
US

V. Phone/Fax

Practice location:
  • Phone: 787-216-8453
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDRIK RAMIREZ GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-216-8453