Provider Demographics
NPI:1790178465
Name:FED MEDICAL CARE INC
Entity Type:Organization
Organization Name:FED MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-708-6997
Mailing Address - Street 1:100 CARR 165
Mailing Address - Street 2:SUITE C 106
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-8047
Mailing Address - Country:US
Mailing Address - Phone:787-708-6997
Mailing Address - Fax:787-708-6998
Practice Address - Street 1:100 CARR 165
Practice Address - Street 2:SUITE C 106
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-8047
Practice Address - Country:US
Practice Address - Phone:787-708-6997
Practice Address - Fax:787-708-6998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR015496261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care