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General NPI Number Information
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NPI Number | 1790178465
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Entity Type | Organization
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Legal Business Name | FED MEDICAL CARE INC
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 100 CARR 165 SUITE C 106
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City | GUAYNABO
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State | PR
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Zip | 00968-8047
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Country | US
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Telephone | 787-708-6997
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Fax | 787-708-6998
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Provider Business Mailing Address
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Address Line | 100 CARR 165 SUITE C 106
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City | GUAYNABO
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State | PR
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Zip | 00968-8047
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Country | US
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Telephone | 787-708-6997
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Fax | 787-708-6998
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Authorized Official
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Title or Position | CEO
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Name | MR. ANGEL M RIVERA
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Credential |
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Telephone | 787-708-6997
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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 | 015496
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License Number State | PR
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