Provider Demographics
NPI:1619013067
Name:MIGRANT HEALTH CENTER
Entity Type:Organization
Organization Name:MIGRANT HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR EJECUTIVO
Authorized Official - Prefix:DR
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-831-5800
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0190
Mailing Address - Country:US
Mailing Address - Phone:787-831-5800
Mailing Address - Fax:787-832-0740
Practice Address - Street 1:BO MONTALVA 23
Practice Address - Street 2:ENSENADA
Practice Address - City:GUANICA
Practice Address - State:PR
Practice Address - Zip Code:00647
Practice Address - Country:US
Practice Address - Phone:787-821-4511
Practice Address - Fax:787-821-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F17373336C0002X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4022175OtherNABP NUMBER