Provider Demographics
NPI:1285036616
Name:RECINTO DE CIENCIAS MEDICAS
Entity Type:Organization
Organization Name:RECINTO DE CIENCIAS MEDICAS
Other - Org Name:RECINTO DE CIENCIAS MEDICAS-MEDICINA GENERAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:787-758-2525
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-274-8156
Practice Address - Street 1:UNIVERSIDAD DE PUERTO RICO
Practice Address - Street 2:RECINTO DE CIENCIAS MEDICAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00929-0134
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-274-8156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health