Provider Demographics
NPI:1124379409
Name:DOCTORS EXPRESS CORP
Entity Type:Organization
Organization Name:DOCTORS EXPRESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RIVERA IGLESIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-599-5417
Mailing Address - Street 1:1353 AVE LUIS VIGOREAUX
Mailing Address - Street 2:PMB 677
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2715
Mailing Address - Country:US
Mailing Address - Phone:787-599-5417
Mailing Address - Fax:787-294-5559
Practice Address - Street 1:C5 CALLE GARDEN MDW
Practice Address - Street 2:GARDEN HILLS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2607
Practice Address - Country:US
Practice Address - Phone:787-599-5417
Practice Address - Fax:787-294-5559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty