Provider Demographics
NPI:1609278977
Name:CARIBBEAN CANCER CARE UNLIMITED PSC
Entity Type:Organization
Organization Name:CARIBBEAN CANCER CARE UNLIMITED PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-284-4830
Mailing Address - Street 1:2225 PONCE BY PASS
Mailing Address - Street 2:EDIFICIO PARRA SUITE 607
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717
Mailing Address - Country:US
Mailing Address - Phone:787-284-4830
Mailing Address - Fax:787-841-1149
Practice Address - Street 1:2225 PONCE BY PASS
Practice Address - Street 2:EDIFICIO PARRA SUITE 701
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-284-4830
Practice Address - Fax:787-841-1149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncologyGroup - Multi-Specialty