Provider Demographics
NPI:1114799624
Name:PREVENTION DIAGNOSTICS CENTER INC
Entity Type:Organization
Organization Name:PREVENTION DIAGNOSTICS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGRI
Authorized Official - Middle Name:C
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-433-4345
Mailing Address - Street 1:M34 CALLE ESTRELLA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-2147
Mailing Address - Country:US
Mailing Address - Phone:787-433-4345
Mailing Address - Fax:
Practice Address - Street 1:URB VISTA DEL MORRO
Practice Address - Street 2:CALLE HALCON LOCAL 2
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962
Practice Address - Country:US
Practice Address - Phone:787-433-4345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service