Provider Demographics
NPI:1649753823
Name:PROVIDERS CARE NETWORK INC.
Entity Type:Organization
Organization Name:PROVIDERS CARE NETWORK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-643-0153
Mailing Address - Street 1:1605 AVE PONCE DE LEON STE 600
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1813
Mailing Address - Country:US
Mailing Address - Phone:787-643-0153
Mailing Address - Fax:
Practice Address - Street 1:1605 AVE PONCE DE LEON STE 600
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1813
Practice Address - Country:US
Practice Address - Phone:787-643-0153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty