Provider Demographics
NPI:1164144424
Name:GRAULAU CARE CLINIC
Entity Type:Organization
Organization Name:GRAULAU CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAULAU ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-923-9958
Mailing Address - Street 1:215 URB SIERRA REAL
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9004
Mailing Address - Country:US
Mailing Address - Phone:787-923-9958
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE JOSE PADILLA EL CARIBE
Practice Address - Street 2:(PLANTA BAJA)
Practice Address - City:CIDRA, PR
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-590-1722
Practice Address - Fax:787-924-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty