Provider Demographics
NPI:1720582828
Name:BORINQUEN HEALTH CARE CENTER INC
Entity Type:Organization
Organization Name:BORINQUEN HEALTH CARE CENTER INC
Other - Org Name:BORINQUEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-576-6611
Mailing Address - Street 1:3601 FEDERAL HWY STE 125
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3795
Mailing Address - Country:US
Mailing Address - Phone:305-422-1140
Mailing Address - Fax:786-953-8270
Practice Address - Street 1:3601 FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3795
Practice Address - Country:US
Practice Address - Phone:305-576-5854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BORINQUEN HEALTH CARE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-22
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy