Healthcare Provider Details

I. General information

NPI: 1225360860
Provider Name (Legal Business Name): CENTRO DE SERVICIOS MEDICOS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HF16 CALLE LIZZIE GRAHAM ESQ. AVE. SABANA SECA
TOA BAJA PR
00949-3634
US

IV. Provider business mailing address

PO BOX 51513
TOA BAJA PR
00950-1513
US

V. Phone/Fax

Practice location:
  • Phone: 787-795-2935
  • Fax: 787-784-0680
Mailing address:
  • Phone: 787-795-2935
  • Fax: 787-784-0680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number14-F-2795
License Number StatePR

VIII. Authorized Official

Name: ARELYS ROSADO
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 787-795-2935