Healthcare Provider Details

I. General information

NPI: 1689752461
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO COMERCIAL REPARTO METROPOLITANO SUITE 211 AVE. AMERICO MIRANDA
RIO PIEDRAS PR
00921
US

IV. Provider business mailing address

OBSTETRICIA Y GINECOLOGIA RCM PO BOX 29134
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-7910
  • Fax: 787-274-8156
Mailing address:
  • Phone: 787-758-2525
  • Fax: 787-274-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MYRIAM TROCHE
Title or Position: CREDENTIALING COORDINATOR
Credential: RHIA
Phone: 787-754-9165