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General NPI Number Information
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NPI Number | 1245309632
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Entity Type | Organization
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Legal Business Name | RECINTO DE CIENCIAS MEDICAS
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | AVE AMERICO MIRANDA APTDO.29134 CENTRO MEDICO DE PR EDIF PRINCIPAL ESCUELA DE MEDICINA
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City | SAN JUAN
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State | PR
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Zip | 00929-0134
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Country | US
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Telephone | 787-758-2525
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Fax | 787-274-8156
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Provider Business Mailing Address
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Address Line | PO BOX 29134
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City | SAN JUAN
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State | PR
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Zip | 00929-0134
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Country | US
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Telephone | 787-758-2525
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Fax | 787-274-8156
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MRS. MYRIAM TROCHE
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Credential | RHIA
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Telephone | 787-758-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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