Provider Demographics
NPI:1629491857
Name:CENTRO ONCOLOGICO INTEGRAL DE PUERTO RICO INC
Entity Type:Organization
Organization Name:CENTRO ONCOLOGICO INTEGRAL DE PUERTO RICO INC
Other - Org Name:COIPR
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-613-3237
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783-0008
Mailing Address - Country:US
Mailing Address - Phone:787-798-9578
Mailing Address - Fax:
Practice Address - Street 1:100 PASEO SAN PABLO
Practice Address - Street 2:EDIFICIO ARTURO CADILLA SUITE 208
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7028
Practice Address - Country:US
Practice Address - Phone:787-798-9578
Practice Address - Fax:787-993-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003003101YP2500X
103TC1900X, 261QI0500X
PR1636133N00000X
PR15917207R00000X
PR12301207RH0003X
PR14119208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty