Provider Demographics
NPI:1598824765
Name:UNIVERSIDAD CENTRAL DEL CARIBE, INC.
Entity Type:Organization
Organization Name:UNIVERSIDAD CENTRAL DEL CARIBE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE UCC
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:G
Authorized Official - Last Name:RODRIGUEZ-IRISARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-798-3001
Mailing Address - Street 1:PO BOX 60327
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-6032
Mailing Address - Country:US
Mailing Address - Phone:787-798-3001
Mailing Address - Fax:787-778-0460
Practice Address - Street 1:AVENIDA LAUREL
Practice Address - Street 2:ESQUINA SANTA JUANITA 100
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-6032
Practice Address - Country:US
Practice Address - Phone:787-798-3001
Practice Address - Fax:787-778-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0029900Medicare PIN