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General NPI Number Information
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NPI Number | 1194172437
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Entity Type | Organization
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Legal Business Name | CENTRO TERAS INC
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 65 AVE DE INFANTERIA PLAZA ITURREGUI SUITE 222
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City | SAN JUAN
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State | PR
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Zip | 00924-0000
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Country | US
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Telephone | 787-462-5590
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Fax | 787-998-8811
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Provider Business Mailing Address
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Address Line | 65 AVE DE INFANTERIA PLAZA ITURREGUI SUITE 222
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City | SAN JUAN
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State | PR
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Zip | 00924-0000
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Country | US
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Telephone | 787-462-5590
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Fax | 787-998-8811
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Authorized Official
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Title or Position | PRESIDENTE
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Name | ANEIZA URQUIA
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Credential |
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Telephone | 787-462-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 000598
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License Number State | PR
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