Provider Demographics
NPI:1346970712
Name:MEDICO XPRESO
Entity Type:Organization
Organization Name:MEDICO XPRESO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZ I
Authorized Official - Middle Name:ORTIZ
Authorized Official - Last Name:BARRIENTOS
Authorized Official - Suffix:
Authorized Official - Credentials:CLINICAL ADMNISTRATO
Authorized Official - Phone:787-942-3232
Mailing Address - Street 1:P.O. BOX 51255
Mailing Address - Street 2:LEVITTOWN
Mailing Address - City:LEVITTOWN
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1255
Mailing Address - Country:US
Mailing Address - Phone:787-942-3232
Mailing Address - Fax:
Practice Address - Street 1:CARR. 696, ESQ. JOSE EFRON PASEO DEL PLATA
Practice Address - Street 2:BUILDING #4,LOCAL #2
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-942-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health