Provider Demographics
NPI:1811000326
Name:FEMALE CONSULTANTS OF PUERTO RICO,CSP
Entity Type:Organization
Organization Name:FEMALE CONSULTANTS OF PUERTO RICO,CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-848-8214
Mailing Address - Street 1:PO BOX 10419
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0419
Mailing Address - Country:US
Mailing Address - Phone:787-848-8214
Mailing Address - Fax:787-290-8217
Practice Address - Street 1:1113 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0635
Practice Address - Country:US
Practice Address - Phone:787-848-8214
Practice Address - Fax:787-290-8217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPE4477OtherPAN AMERICAN LIFE
PR062285OtherLA CRUZ AZUL DE PR
PR062285OtherLA CRUZ AZUL DE PR
PR=========OtherMAPFRE
PRPE4477OtherPAN AMERICAN LIFE