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General NPI Number Information
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NPI Number | 1619009529
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Entity Type | Organization
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Legal Business Name | CENTRO FAMILIAR MEDICINA AVANZADA
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | B1 CALLE LOPE FLORES URBANIZACION PARADIS
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City | CAGUAS
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State | PR
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Zip | 00726-0000
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Country | US
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Telephone | 787-746-5790
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Fax | 787-746-5790
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Provider Business Mailing Address
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Address Line | PO BOX 1388
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City | CAGUAS
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State | PR
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Zip | 00726-1388
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Country | US
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Telephone | 787-746-5790
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Fax | 787-746-5790
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. JOSE M RODRIGUEZ
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Credential | M.D.
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Telephone | 787-746-5790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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