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General NPI Number Information
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NPI Number | 1609652973
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Entity Type | Organization
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Legal Business Name | CLINICA DE MEDICINA INTERNA PR LLC
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | E50 CALLE MARGINAL
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City | BAYAMON
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State | PR
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Zip | 00959-5513
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Country | US
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Telephone | 787-675-1010
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2117
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City | BAYAMON
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State | PR
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Zip | 00960-2117
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Country | US
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Telephone | 787-675-1010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIELLE SANCHEZ RODRIGUEZ
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Credential | MD
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Telephone | 787-675-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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