MEDICARE: MIGRANT HEALTH CENTER WESTERN REGION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1104544378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIGRANT HEALTH CENTER WESTERN REGION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 190
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0190
Country	:	US
Telephone Number	:	787-831-5800
Fax Number	:	787-832-0740

Provider Business Practice Location Address
First Line	:	180 RES CANDELARIA # 186
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-2714
Country	:	US
Telephone Number	:	787-908-1342
Fax Number	:	787-832-0740

Authorized Official
Title or Position	:	CEO
Name	:	DR. TANIA RODRIGUEZ
Credential	:
Telephone Number	:	787-831-5800

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	04/17/2026

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