Provider Demographics
NPI:1669815254
Name:TRUST MEDICAL AND ONCOLOGY CENTER PSC
Entity Type:Organization
Organization Name:TRUST MEDICAL AND ONCOLOGY CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:A
Authorized Official - Last Name:TALAVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-633-0017
Mailing Address - Street 1:PO BOX 363305
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3305
Mailing Address - Country:US
Mailing Address - Phone:787-633-0017
Mailing Address - Fax:787-710-9886
Practice Address - Street 1:4PN4 VIA JOSEFINA
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983-4828
Practice Address - Country:US
Practice Address - Phone:787-633-0017
Practice Address - Fax:787-710-9886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13091261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology