Provider Demographics
NPI:1356861397
Name:METROHEALTH CENTRAL CORPORATION
Entity Type:Organization
Organization Name:METROHEALTH CENTRAL CORPORATION
Other - Org Name:CLINICA MEDICINA CONDUCTUAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LISANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-650-7272
Mailing Address - Street 1:PO BOX 659
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-650-7275
Mailing Address - Fax:787-650-7310
Practice Address - Street 1:502 BORINQUEN AVENUE
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-7275
Practice Address - Fax:787-650-7310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROHEALTH CENTRAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-21
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)