Provider Demographics
NPI:1821062498
Name:CENTRO DERMATOLOGICO ARECIBO
Entity Type:Organization
Organization Name:CENTRO DERMATOLOGICO ARECIBO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHABRIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-817-2300
Mailing Address - Street 1:AVENIDA BARBOSA 65 SUITE 205
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-817-2300
Mailing Address - Fax:787-817-2345
Practice Address - Street 1:PARQUE CENTRO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-5000
Practice Address - Country:US
Practice Address - Phone:787-817-2300
Practice Address - Fax:787-817-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11283207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty