Provider Demographics
NPI:1255489969
Name:METRO MEDICAL CARIBBEAN CENTER, INC
Entity Type:Organization
Organization Name:METRO MEDICAL CARIBBEAN CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR (CEO)
Authorized Official - Prefix:MRS
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:LUZ
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-782-1422
Mailing Address - Street 1:PO BOX 9024272
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-4272
Mailing Address - Country:US
Mailing Address - Phone:787-782-1422
Mailing Address - Fax:787-728-1424
Practice Address - Street 1:728 AVE DE DIEGO STE 2
Practice Address - Street 2:CAPARRA TERRACE, PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-5006
Practice Address - Country:US
Practice Address - Phone:787-782-1422
Practice Address - Fax:787-728-1424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center