MEDICARE: ALIANZA PROFESIONAL DE CUIDADO MEDICO, 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	305S00000X	Point of Service

General Provider Information

NPI Number	:	1134360191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIANZA PROFESIONAL DE CUIDADO MEDICO, INC.

Provider Business Mailing Address
First Line	:	PO BOX 6598
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-5598
Country	:	US
Telephone Number	:	787-778-0315
Fax Number	:	787-778-0330

Provider Business Practice Location Address
First Line	:	20 CALLE SANTA CRUZ
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961-6906
Country	:	US
Telephone Number	:	787-778-0315
Fax Number	:	787-778-0330

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HECTOR JESUS CANDELAS RODRIGUEZ
Credential	:	MD
Telephone Number	:	787-778-0315

Provider Enumeration Date	:	03/20/2009
Last Update Date	:	03/20/2009

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