Provider Demographics
NPI:1659601516
Name:GRUPO MEDICO DE RIO HONDO Y LEVITTOWN, PSC
Entity Type:Organization
Organization Name:GRUPO MEDICO DE RIO HONDO Y LEVITTOWN, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZARRUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-784-5899
Mailing Address - Street 1:AVE BOULEVARD 2692 2DA SECCION
Mailing Address - Street 2:LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-261-8181
Mailing Address - Fax:787-261-8282
Practice Address - Street 1:AVE BOULEVARD 2692 2DA SECCION
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-261-8181
Practice Address - Fax:787-261-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8996261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE81694Medicare UPIN
E81689Medicare UPIN