MEDICARE: CLINICA DE SALUD INTEGRAL 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	207Q00000X	Family Medicine Physician	009768	PR

General Provider Information

NPI Number	:	1508127580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA DE SALUD INTEGRAL INC

Provider Business Mailing Address
First Line	:	PO BOX 1436
Second Line	:
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-1436
Country	:	US
Telephone Number	:	787-733-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 CALLE VICENTE DE LEON
Second Line	:	BO COLLORES
City	:	LAS PIEDRAS
State	:	PR
Zip	:	00771-3353
Country	:	US
Telephone Number	:	787-733-1725
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HECTOR RAFAEL TORO DENIS
Credential	:	M.D.
Telephone Number	:	787-354-0314

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	06/06/2012

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