Provider Demographics
NPI:1346464005
Name:CENTRO PEDIATRICO LAS AMERICAS C.S.P.
Entity Type:Organization
Organization Name:CENTRO PEDIATRICO LAS AMERICAS C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-721-8383
Mailing Address - Street 1:262 CALLE CONVENTO
Mailing Address - Street 2:APT. # 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912-3207
Mailing Address - Country:US
Mailing Address - Phone:787-721-8383
Mailing Address - Fax:787-722-8484
Practice Address - Street 1:262 CALLE CONVENTO
Practice Address - Street 2:APT. # 1
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3207
Practice Address - Country:US
Practice Address - Phone:787-721-8383
Practice Address - Fax:787-722-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10658174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========Medicare UPIN