Provider Demographics
NPI:1639494982
Name:RECINTO DE CIENCIAS MEDICAS
Entity Type:Organization
Organization Name:RECINTO DE CIENCIAS MEDICAS
Other - Org Name:RECINTO DE CIENCIAS MEDICAS (NEURO CUIDADO CRITICO RCM)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:RHIA
Authorized Official - Phone:787-754-9165
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-754-9165
Mailing Address - Fax:787-274-8156
Practice Address - Street 1:HOSPITAL UNIVERSITARIO DE ADULTOS PRIMER PISO
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO, BO. MANACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-754-0101
Practice Address - Fax:787-274-8156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR207LC0200X, 207T00000X
207RC0200X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty