Provider Demographics
NPI:1568168771
Name:CENTRO MEDICO DIAGNOSTICO MUNOZ RIVERA
Entity Type:Organization
Organization Name:CENTRO MEDICO DIAGNOSTICO MUNOZ RIVERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:SIGFRIDO
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-720-3234
Mailing Address - Street 1:URB MUNOZ RIVERA 59
Mailing Address - Street 2:AVE ESMERALDA
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-720-3234
Mailing Address - Fax:
Practice Address - Street 1:URB MUNOZ RIVERA 59
Practice Address - Street 2:AVE ESMERALDA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-720-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory