Healthcare Provider Details

I. General information

NPI: 1407980782
Provider Name (Legal Business Name): CARIBBEAN GYN CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 AVE. PONCE DE LEON SUITE 614
SAN JUAN PR
00917
US

IV. Provider business mailing address

P.O. BOX 367148
SAN JUAN PR
00936-7148
US

V. Phone/Fax

Practice location:
  • Phone: 787-274-0113
  • Fax: 787-751-4417
Mailing address:
  • Phone: 787-593-4436
  • Fax: 787-751-4417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: HIRAM MALARET
Title or Position: OWNER
Credential:
Phone: 787-593-4436