Provider Demographics
NPI:1649418583
Name:CENTRO DE ACUPUNTURA MEDICA DE PR
Entity Type:Organization
Organization Name:CENTRO DE ACUPUNTURA MEDICA DE PR
Other - Org Name:ACUMEDIX
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:AYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-772-8199
Mailing Address - Street 1:384 AVE DOMENECH
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3719
Mailing Address - Country:US
Mailing Address - Phone:787-772-8199
Mailing Address - Fax:787-772-8199
Practice Address - Street 1:384 AVE DOMENECH
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3719
Practice Address - Country:US
Practice Address - Phone:787-772-8199
Practice Address - Fax:787-772-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health