Healthcare Provider Details

I. General information

NPI: 1164813853
Provider Name (Legal Business Name): CARIBBEAN PAIN INSTITUTE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2015
Last Update Date: 10/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 CARR 176 APT 205
SAN JUAN PR
00926-6677
US

IV. Provider business mailing address

400 CARR 176 APT 205
SAN JUAN PR
00926-6677
US

V. Phone/Fax

Practice location:
  • Phone: 787-675-6200
  • Fax: 787-272-5196
Mailing address:
  • Phone: 787-675-6200
  • Fax: 787-272-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number18,242
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number18,242
License Number StatePR

VIII. Authorized Official

Name: DR. CARLOS E CALVO
Title or Position: CEO - PAIN MANAGEMENT PHYSICIAN
Credential: MD
Phone: 787-675-6200