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General NPI Number Information
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NPI Number | 1699323691
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Entity Type | Organization
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Legal Business Name | CENTRO ARARAT INC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/09/2019
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Provider Practice Location Address
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Address Line | 60 CALLE DOMINGO RUBIO
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City | ARECIBO
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State | PR
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Zip | 00612-4473
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Country | US
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Telephone | 787-680-0236
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Fax | 787-816-5715
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Provider Business Mailing Address
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Address Line | PO BOX 7793
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City | PONCE
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State | PR
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Zip | 00732-7793
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Country | US
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Telephone | 787-284-5884
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Fax | 787-651-3333
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | IVAN MELENDEZ-RIVERA
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Credential | MD
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Telephone | 787-284-5884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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