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General NPI Number Information
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NPI Number | 1811031933
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Entity Type | Organization
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Legal Business Name | CENTRO MEDICO DEL TURABO INC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | HIMA SAN PABLO CAGUAS AVE LUIS MUNOZ MARIN CEPA
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-653-3434
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Fax | 787-961-1901
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Provider Business Mailing Address
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Address Line | PO BOX 4980
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-653-2224
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Fax | 787-653-2217
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ORLANDO RIVERA
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Credential | LCDO
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Telephone | 787-653-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | 13102
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License Number State | PR
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