Provider Demographics
NPI:1215390562
Name:CENTRO SERVICIOS DE SALUD TOA ALTA
Entity Type:Organization
Organization Name:CENTRO SERVICIOS DE SALUD TOA ALTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEC
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-230-7190
Mailing Address - Street 1:IF 48 AVE LOMAS VERDES
Mailing Address - Street 2:ROYAL PALM
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3114
Mailing Address - Country:US
Mailing Address - Phone:787-520-8449
Mailing Address - Fax:
Practice Address - Street 1:CARR. 861 INT. 829 KM 5.8 BO.
Practice Address - Street 2:PINAS
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-230-7190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory