Healthcare Provider Details

I. General information

NPI: 1225271828
Provider Name (Legal Business Name): RAPIDCLINICCSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CALLE ARZUAGA STE 605
SAN JUAN PR
00925-3316
US

IV. Provider business mailing address

ARZUAGA 112 SUITE 605
SAN JUAN PR
00925
US

V. Phone/Fax

Practice location:
  • Phone: 787-646-0202
  • Fax: 787-763-0200
Mailing address:
  • Phone: 787-646-0202
  • Fax: 787-763-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1862771
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1862771
License Number StatePR

VIII. Authorized Official

Name: DR. PEREIRA ESTRADA OMAYRA
Title or Position: PRESIDENTE
Credential: MD
Phone: 787-646-0202