Provider Demographics
NPI:1073721064
Name:CENTRO CLINICO DE DISTURBIOS DEL SUENO
Entity Type:Organization
Organization Name:CENTRO CLINICO DE DISTURBIOS DEL SUENO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-692-8304
Mailing Address - Street 1:SUITE 112 PMB 182
Mailing Address - Street 2:100 GRAND BLVD PASEOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-778-5000
Mailing Address - Fax:787-778-5010
Practice Address - Street 1:URB HERMANAS DAVILA
Practice Address - Street 2:J 14 CALLE 2
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-778-5000
Practice Address - Fax:787-778-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic