Provider Demographics
NPI:1336296011
Name:RIO PIEDRAS PLAZA MEDICAL
Entity Type:Organization
Organization Name:RIO PIEDRAS PLAZA MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:T
Authorized Official - Last Name:OJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-6019
Mailing Address - Street 1:76 CALLE GEORGETTI
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-3641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:76 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3641
Practice Address - Country:US
Practice Address - Phone:787-765-6019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRS53229129418332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4827680001Medicare NSC