Provider Demographics
NPI:1043221666
Name:UNIV CENTRAL DEL CARIBE
Entity Type:Organization
Organization Name:UNIV CENTRAL DEL CARIBE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE UCC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:RODRIGUEZ-IRIZARRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-798-3001
Mailing Address - Street 1:PO BOX 60327
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-6032
Mailing Address - Country:US
Mailing Address - Phone:787-798-3001
Mailing Address - Fax:787-778-0460
Practice Address - Street 1:AVENIDA LAUREL
Practice Address - Street 2:ESQUINA SANTA JUANITA #100
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-798-3001
Practice Address - Fax:787-778-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0770OtherINTERNATIONAL MEDICAL CAR
6919061OtherCIGNA
060890OtherCRUZ AZUL
84785OtherSSS
9560090OtherHUMANA
=========OtherMAPFRE
0770OtherINTERNATIONAL MEDICAL CAR
=========OtherMMM
=========KOtherMEDICAL CARD SYSTEM