Provider Demographics
NPI:1578534202
Name:CENTRO DE ADULTOS Y NINOS CON IMPEDIMENTOS INC.
Entity Type:Organization
Organization Name:CENTRO DE ADULTOS Y NINOS CON IMPEDIMENTOS INC.
Other - Org Name:CANII
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:RAMOS-VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BBA
Authorized Official - Phone:787-872-8365
Mailing Address - Street 1:DR. GONZALEZ 133 STREET
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-872-8365
Mailing Address - Fax:787-872-4111
Practice Address - Street 1:133 CALLE DR GONZALEZ
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2633
Practice Address - Country:US
Practice Address - Phone:787-872-8365
Practice Address - Fax:787-872-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR008-5057Medicare ID - Type Unspecified
PRY44089Medicare UPIN