Healthcare Provider Details

I. General information

NPI: 1548691579
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2013
Last Update Date: 12/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA AMERICO MIRANDA CENTRO COMERCIAL REPARTO METROPOLITANO
RIO PIEDRAS PR
00929-0134
US

IV. Provider business mailing address

PO BOX 29134
SAN JUAN PR
00929-0134
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0200X
TaxonomyOncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANA RAMOS
Title or Position: ADMINISTRATIVE ASISTANT
Credential:
Phone: 787-754-9165