1063625333 NPI number — CENTRO MED TURABO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063625333 NPI number — CENTRO MED TURABO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRO MED TURABO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063625333
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 GRAND BLVD PASEOS
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-5955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-292-0600
Provider Business Mailing Address Fax Number:
787-761-2094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SALA DE EMERGENCIA HIMA
Provider Second Line Business Practice Location Address:
AVE. MUNOZ MARIN, ESQ. DEGETAU
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-653-3434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAPULVEDA
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
787-292-0600

Provider Taxonomy Codes

  • Taxonomy code: 207PH0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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