Provider Demographics
NPI:1720205289
Name:CENTRO MEDICO DEL TURABO INC
Entity Type:Organization
Organization Name:CENTRO MEDICO DEL TURABO INC
Other - Org Name:GRUPO ORTOPEDIA AVANZADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:ANGEL T MALDONADO
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:787-653-1296
Practice Address - Street 1:URB SANTA CRUZ HIMA BAYAMON
Practice Address - Street 2:SANTA CRUZ 70
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00970
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:787-653-1296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRMEDICAL LICENSEOther9861