Provider Demographics
NPI:1003235615
Name:CENTRO DE SERVICIOS DE SALUD DE BAYAMON
Entity Type:Organization
Organization Name:CENTRO DE SERVICIOS DE SALUD DE BAYAMON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEC
Authorized Official - Middle Name:MANUELY
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-241-4229
Mailing Address - Street 1:IF-48 AVE. LOMAS VERDES
Mailing Address - Street 2:URB. ROYAL PALM
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-241-4229
Mailing Address - Fax:
Practice Address - Street 1:72-26 CALLE 45
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4310
Practice Address - Country:US
Practice Address - Phone:787-241-4229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health