Healthcare Provider Details

I. General information

NPI: 1649831777
Provider Name (Legal Business Name): MOROVIS COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2019
Last Update Date: 06/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO CANDELARIA SECTOR PAJAROS PR 863 KM 1.0
TOA BAJA PR
00949
US

IV. Provider business mailing address

PO BOX 518
MOROVIS PR
00687-0518
US

V. Phone/Fax

Practice location:
  • Phone: 787-862-3000
  • Fax: 787-862-2731
Mailing address:
  • Phone: 787-862-3000
  • Fax: 787-862-2731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LIRIO ANTONIA DIAZ
Title or Position: OFFICIAL ADMINISTRATOR
Credential:
Phone: 787-862-3000