Healthcare Provider Details

I. General information

NPI: 1417552209
Provider Name (Legal Business Name): MED CENTRO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 09/05/2024
Certification Date: 08/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 149 KM 57.7 VILLALBA ARRIBA
VILLALBA PR
00766
US

IV. Provider business mailing address

PO BOX 220
MERCEDITA PR
00715-0220
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-9393
  • Fax: 787-841-0077
Mailing address:
  • Phone: 787-843-9393
  • Fax: 787-841-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ALLAN CINTRON SALICHS
Title or Position: EXECUTIVE DIRECTOR
Credential: MBA, MHCM
Phone: 787-843-9393