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General NPI Number Information
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NPI Number | 1467767079
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Entity Type | Organization
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Legal Business Name | CENTRO DE SERVICIOS MEDICOS INC
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | LIZZIE GRAHAM HF16 SEPTIMA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-0000
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Country | US
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Telephone | 787-795-2935
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Fax | 787-784-0680
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Provider Business Mailing Address
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Address Line | LIZZIE GRAHAM HF16 SEPTIMA SECCION LEVITTOWN
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City | TOA BAJA
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State | PR
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Zip | 00949-0000
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Country | US
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Telephone | 787-795-2935
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Fax | 787-784-0680
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MR. RAFAEL L ROIG
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Credential |
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Telephone | 787-795-4810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number | 51
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License Number State | PR
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