Healthcare Provider Details

I. General information

NPI: 1972843209
Provider Name (Legal Business Name): CARE TRANSITION PROGRAM BM, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2013
Last Update Date: 02/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 AVE PONCE DE LEON SUITE 1219
SAN JUAN PR
00909-1703
US

IV. Provider business mailing address

1519 AVE PONCE DE LEON SUITE 1219
SAN JUAN PR
00909-1703
US

V. Phone/Fax

Practice location:
  • Phone: 787-562-5168
  • Fax: 787-722-2374
Mailing address:
  • Phone: 787-562-5168
  • Fax: 787-722-2374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MRS. YAMILET LOPEZ
Title or Position: ADMINISTRATOR
Credential: MBA
Phone: 787-562-5168