Provider Demographics
NPI:1538518261
Name:PREVENTIVE CARE SERVICES BY APEX
Entity Type:Organization
Organization Name:PREVENTIVE CARE SERVICES BY APEX
Other - Org Name:APEX CAPTAL CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAMBRANA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:787-651-1435
Mailing Address - Street 1:909 AVE TITO CASTRO
Mailing Address - Street 2:TORRE MEDICA HOSPITAL SUITE 105
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0105
Mailing Address - Country:US
Mailing Address - Phone:787-651-1435
Mailing Address - Fax:787-651-6362
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:TORRE MEDICA HOSPITAL SAN LUCAS SUITE 105
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0105
Practice Address - Country:US
Practice Address - Phone:787-651-1435
Practice Address - Fax:787-651-6362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16659261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care