Healthcare Provider Details

I. General information

NPI: 1265478028
Provider Name (Legal Business Name): RINCON MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 STREET KM 13.1
RINCON PR
00677
US

IV. Provider business mailing address

PO BOX 419
VEGA ALTA PR
00692
US

V. Phone/Fax

Practice location:
  • Phone: 787-823-0909
  • Fax: 787-823-0904
Mailing address:
  • Phone: 787-823-0909
  • Fax: 787-823-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS M GONZALEZ BERMUDEZ
Title or Position: DIRECTOR MEDICO
Credential:
Phone: 787-278-3331