Provider Demographics
NPI:1063639755
Name:CENTRO DE ESPECIALISTAS CUIDAD DEL YUNQUE
Entity Type:Organization
Organization Name:CENTRO DE ESPECIALISTAS CUIDAD DEL YUNQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:APONTE ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-888-5406
Mailing Address - Street 1:PO BOX 2276
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-2276
Mailing Address - Country:US
Mailing Address - Phone:787-888-5406
Mailing Address - Fax:787-888-5406
Practice Address - Street 1:VILLAS DE RIO GRANDE
Practice Address - Street 2:CALLE GARCIA DE LA NOCEDA B 23
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-888-5406
Practice Address - Fax:787-888-5406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10780261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF47602Medicare UPIN
PR82913Medicare ID - Type Unspecified