Healthcare Provider Details

I. General information

NPI: 1255256897
Provider Name (Legal Business Name): CENTRO REUMATOLOGICO DEL OESTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EDIFICIO SAN VICENTE DE PAUL OFICINA 308
SAN GERMAN PR
00683
US

IV. Provider business mailing address

131 CALLE ROSARIO
CABO ROJO PR
00623-3913
US

V. Phone/Fax

Practice location:
  • Phone: 939-319-1794
  • Fax:
Mailing address:
  • Phone: 939-319-1794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWIN JOSE PLAZA LAMOLI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 939-319-1794