Provider Demographics
NPI:1578849048
Name:POLICLINICA LAS AMERICAS MEDICAL CENTER INC
Entity Type:Organization
Organization Name:POLICLINICA LAS AMERICAS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:REYES CABEZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-856-0844
Mailing Address - Street 1:PMB 281
Mailing Address - Street 2:AVE MUNOZ RIVERA 1575
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0211
Mailing Address - Country:US
Mailing Address - Phone:787-856-0844
Mailing Address - Fax:787-290-4472
Practice Address - Street 1:2015 BLVD LUIS A FERRE STE 101
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0798
Practice Address - Country:US
Practice Address - Phone:787-842-8945
Practice Address - Fax:787-290-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR85050Medicare PIN