Healthcare Provider Details

I. General information

NPI: 1962970798
Provider Name (Legal Business Name): CENTRO DE SALUD FAMILIAR SAN MIGUEL ARCANGEL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SAN MIGUEL #2
UTUADO PR
00641
US

IV. Provider business mailing address

CALLE SAN MIGUEL #2
UTUADO PR
00641
US

V. Phone/Fax

Practice location:
  • Phone: 787-894-2288
  • Fax: 787-894-5731
Mailing address:
  • Phone: 787-894-2288
  • Fax: 787-894-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JUAN LUIS CAPARROS GONZALEZ SR.
Title or Position: PRESIDENT
Credential: MD
Phone: 939-235-8227