Provider Demographics
NPI:1679852826
Name:CENTRO MEDICO DEL TURABO INC
Entity Type:Organization
Organization Name:CENTRO MEDICO DEL TURABO INC
Other - Org Name:GRUPO CARDIOLOGIA PEDIATRICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:LCDO
Authorized Official - Phone:787-653-3434
Mailing Address - Street 1:PO BOX 4980
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4980
Mailing Address - Country:US
Mailing Address - Phone:787-653-3434
Mailing Address - Fax:787-961-1901
Practice Address - Street 1:AVE LUIS MUNOZ MARIN 100
Practice Address - Street 2:URB MARIOLGA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:787-961-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty