Provider Demographics
NPI:1477516359
Name:COMMUNITY HEALTH CARE NETWORK CORP.
Entity Type:Organization
Organization Name:COMMUNITY HEALTH CARE NETWORK CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-276-1743
Mailing Address - Street 1:PO BOX 9059
Mailing Address - Street 2:PLAZA CAROLINA STATION
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-9059
Mailing Address - Country:US
Mailing Address - Phone:787-276-1743
Mailing Address - Fax:787-283-1356
Practice Address - Street 1:GP8 AVE ROBERTO SANCHEZ VILELLA
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2677
Practice Address - Country:US
Practice Address - Phone:787-276-1743
Practice Address - Fax:787-283-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83966Medicare ID - Type Unspecified