Provider Demographics
NPI:1124406210
Name:RECINTO DE CIENCIAS MEDICAS
Entity Type:Organization
Organization Name:RECINTO DE CIENCIAS MEDICAS
Other - Org Name:RECINTO DE CIENCIAS MEDICAS (GERIATRIA RCM)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-754-9165
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:GERIATRIA RCM
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-754-9165
Mailing Address - Fax:787-274-8156
Practice Address - Street 1:AVE. AMERICO MIRANDA REPARTO METROPOLITANO SHOPPING
Practice Address - Street 2:CLINICA DE LA ESCUELA DE MEDICINA
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-758-7910
Practice Address - Fax:787-625-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty