Provider Demographics
NPI:1417969411
Name:MOROVIS COMMUNITY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:MOROVIS COMMUNITY HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ-CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-862-3000
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:2 PATRON STREET
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-0518
Mailing Address - Country:US
Mailing Address - Phone:787-862-3000
Mailing Address - Fax:787-862-2731
Practice Address - Street 1:2 PATRON STREET
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-0518
Practice Address - Country:US
Practice Address - Phone:787-862-3000
Practice Address - Fax:787-862-2731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20261QC1500X
261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30753OtherCRUZ AZUL
PR0119792OtherACAA
PR200247OtherPREFERRED HEALTH
PR6870002OtherHUMANA
PR40006OtherPMC
PR40006-BOtherPMC DR. SANCHEZ
PR40006-COtherPMC DRA. GONZALEZ
PR40006-DOtherPMC DR. CASIANO
PR40006-FOtherPMC DRA. RIVERA
PR6870002OtherHUMANA
PR30753OtherCRUZ AZUL
PR100055Medicare ID - Type UnspecifiedMMM DR. RIVERA
PR40006-DOtherPMC DR. CASIANO
PR0119792OtherACAA
PR=========OtherMCS
PR40006OtherPMC