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General NPI Number Information
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NPI Number | 1346214129
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Entity Type | Organization
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Legal Business Name | RS CENTRO MEDICINA AVANZADA, CORP
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Dates
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Enumeration Date | 02/16/2006
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 20 CALLE BOBBY CAPO
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City | COAMO
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State | PR
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Zip | 00769-2416
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Country | US
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Telephone | 787-803-0040
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Fax | 787-803-0070
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Provider Business Mailing Address
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Address Line | 20 CALLE BOBBY CAPO
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City | COAMO
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State | PR
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Zip | 00769-2416
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Country | US
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Telephone | 787-803-0040
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Fax | 787-803-0070
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LEYDA LOPEZ MARTINEZ
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Credential | RN
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Telephone | 787-803-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 04PU7-00000-04656
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License Number State | PR
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