Provider Demographics
NPI:1598989527
Name:CENTROS DE PREVENCION TRATAMIENTO DE ENFERMEDADES TRANSMISIBLES
Entity Type:Organization
Organization Name:CENTROS DE PREVENCION TRATAMIENTO DE ENFERMEDADES TRANSMISIBLES
Other - Org Name:CLINICA INMUNOLOGICA DE HUMACAO
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRETOR EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:787-771-2100
Mailing Address - Street 1:CLINICA INMUNOLOGICA DE HUMACAO
Mailing Address - Street 2:BOX 8548
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8548
Mailing Address - Country:US
Mailing Address - Phone:787-704-7066
Mailing Address - Fax:787-746-2896
Practice Address - Street 1:100 CALLE FONT MARTELO W
Practice Address - Street 2:CLINICA INMUNOLOGICA DE HUMACAO LOCAL 13Y14
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3923
Practice Address - Country:US
Practice Address - Phone:787-704-7066
Practice Address - Fax:787-746-2896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR101239OtherMEDICO Y LAB
PR7250066OtherMEDICO Y LAB
PR660433481-16OtherMEDICO
PR30346OtherLAB
PR660433481-17OtherLAB
PR7250066OtherMEDICO Y LAB