Healthcare Provider Details

I. General information

NPI: 1568907574
Provider Name (Legal Business Name): RECINTO DE CIENCIAS MEDICAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO DE PR. BO MONACILLOS
SAN JUAN PR
00935
US

IV. Provider business mailing address

PO BOX 29134 MEDICINA PALIATIVA
SAN JUAN PR
00929-0134
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3760
  • Fax: 787-777-3781
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: MRS. DIANA RAMOS
Title or Position: ADMINISTRATIVE ASISTANT
Credential:
Phone: 787-758-2525