Provider Demographics
NPI:1245421908
Name:CORPORACION DE SALUD INTEGRAL Y
Entity Type:Organization
Organization Name:CORPORACION DE SALUD INTEGRAL Y
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-413-6196
Mailing Address - Street 1:PO BOX 6021
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6021
Mailing Address - Country:US
Mailing Address - Phone:787-263-5136
Mailing Address - Fax:787-263-5136
Practice Address - Street 1:HOSPITAL GENERAL MENONITA-CAYEY
Practice Address - Street 2:EDIF PROF- SUITE 303
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:787-535-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14167207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty