Provider Demographics
NPI:1619240082
Name:CENTRO INTEGRADO DE CANCER DEL SUR, PSC
Entity Type:Organization
Organization Name:CENTRO INTEGRADO DE CANCER DEL SUR, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-366-7772
Mailing Address - Street 1:PO BOX 801013
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1013
Mailing Address - Country:US
Mailing Address - Phone:787-366-7773
Mailing Address - Fax:
Practice Address - Street 1:CARR. 506 KM 1.0
Practice Address - Street 2:TORRE SAN CRISTOBAL SUITE 408
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-0000
Practice Address - Country:US
Practice Address - Phone:787-366-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO INTEGRADO DE CANCER DEL SUR, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8170261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology