Healthcare Provider Details

I. General information

NPI: 1710275144
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OFIC. 563 EDIF. PRINCIPAL RCM CENTRO MEDICO DE PUERTO RICO
RIO PIEDRAS PR
00935-0000
US

IV. Provider business mailing address

PO BOX 29134 CENTRO DE ENFERMEDADES HEREDITARIAS DE PR
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-754-9165
  • Fax: 787-274-8156
Mailing address:
  • Phone: 787-754-9165
  • Fax: 787-274-8156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207SG0203X
TaxonomyClinical Molecular Genetics Physician
License Number
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number StatePR
# 8
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number StatePR
# 9
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StatePR
# 10
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number
License Number StatePR
# 11
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StatePR
# 12
Primary TaxonomyN
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State
# 13
Primary TaxonomyN
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License Number
License Number StatePR
# 14
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: SHAYRA C. MORALES
Title or Position: ADM. SECRETARY
Credential:
Phone: 787-754-9165