Provider Demographics
NPI:1407308414
Name:FAMILY CLINICAL RESEARCH CORPORATION
Entity Type:Organization
Organization Name:FAMILY CLINICAL RESEARCH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-757-8065
Mailing Address - Street 1:PO BOX 1626
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-1626
Mailing Address - Country:US
Mailing Address - Phone:787-757-8065
Mailing Address - Fax:787-768-8392
Practice Address - Street 1:R511 SANCHEZ OSORIO AVENUE 2T
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-3205
Practice Address - Country:US
Practice Address - Phone:787-757-8065
Practice Address - Fax:787-768-8392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4445261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79453Medicare UPIN