Provider Demographics
NPI:1659705143
Name:HEAL MEDICAL CENTER, P.S.C.
Entity Type:Organization
Organization Name:HEAL MEDICAL CENTER, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-210-8235
Mailing Address - Street 1:COLINAS METROPOLITANAS
Mailing Address - Street 2:H23 CALLE COLLORES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5209
Mailing Address - Country:US
Mailing Address - Phone:787-993-1536
Mailing Address - Fax:
Practice Address - Street 1:6 CALLE HERMINIO MIRANDA
Practice Address - Street 2:ESQUINA COMERCIO
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-6001
Practice Address - Country:US
Practice Address - Phone:787-369-1336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15876261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI-29377Medicare UPIN