Provider Demographics
NPI:1689728875
Name:CENTRO MEDICO DEL TURABO INC
Entity Type:Organization
Organization Name:CENTRO MEDICO DEL TURABO INC
Other - Org Name:GRUPO QUIRURGICO AVANZADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR EJECUTIVO
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:A1 AVE MUNOZ RIVERA
Practice Address - Street 2:
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:2007-01-23
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8222207T00000X
PR16218208600000X
PR16224208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR$$$$$$$$$OtherSOCIAL SECURITY
PR$$$$$$$$$OtherSOCIAL SECURITY
PR$$$$$$$$$OtherSOCIAL SECURITY