Provider Demographics
NPI:1508127580
Name:CLINICA DE SALUD INTEGRAL INC
Entity Type:Organization
Organization Name:CLINICA DE SALUD INTEGRAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:TORO DENIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-354-0314
Mailing Address - Street 1:PO BOX 1436
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-1436
Mailing Address - Country:US
Mailing Address - Phone:787-733-1725
Mailing Address - Fax:
Practice Address - Street 1:18 CALLE VICENTE DE LEON
Practice Address - Street 2:BO COLLORES
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-3353
Practice Address - Country:US
Practice Address - Phone:787-733-1725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR009768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE71292Medicare UPIN
PR0082196Medicare PIN