Provider Demographics
NPI:1003018052
Name:MOROVIS COMMUNITY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:MOROVIS COMMUNITY HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIRIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-862-3000
Mailing Address - Street 1:2 CALLE PATRON
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-3021
Mailing Address - Country:US
Mailing Address - Phone:787-862-3000
Mailing Address - Fax:787-862-2731
Practice Address - Street 1:2 CALLE PATRON
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3021
Practice Address - Country:US
Practice Address - Phone:787-862-3000
Practice Address - Fax:787-862-2731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR030753OtherCRUZ AZUL DE PUERTO RICO
PR22222OtherPROSAM
PR5679OtherAMERICAN HEALTH MEDICARE
PR600091OtherPREFERRED HEALTH
PR19594OtherSSS CCC SELECTO
PR40006OtherPMC
PR6870002OtherHUMANA
PR400269OtherACAA
PR400269OtherACAA
PR401807Medicare ID - Type UnspecifiedMEDICARE FQHC
PR400269OtherACAA
PR030753OtherCRUZ AZUL DE PUERTO RICO
PR600091OtherPREFERRED HEALTH
PRG40364Medicare UPIN
PRF47546Medicare UPIN
PRI38184Medicare UPIN
PR82747Medicare ID - Type UnspecifiedPROVIDER #