Provider Demographics
NPI:1346576634
Name:CLINICA INTEGRAL DE SALUD SAN JUAN HEALTH CENTRE INC
Entity Type:Organization
Organization Name:CLINICA INTEGRAL DE SALUD SAN JUAN HEALTH CENTRE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-977-7575
Mailing Address - Street 1:AVENIDA DE DIEGI #150 ESQUINA BALDORIOTY DE CASTRO
Mailing Address - Street 2:CONDOMINIO SAN JUAN HEALTH CENTRE
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00907
Mailing Address - Country:AX
Mailing Address - Phone:787-977-7575
Mailing Address - Fax:787-977-7587
Practice Address - Street 1:AVENIDA DE DIEGI #150 ESQUINA BALDORIOTY DE CASTRO
Practice Address - Street 2:CONDOMINIO SAN JUAN HEALTH CENTRE
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00907
Practice Address - Country:AX
Practice Address - Phone:787-977-7575
Practice Address - Fax:787-977-7587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty