Provider Demographics
NPI:1851632780
Name:METRO PAVIA HEALTHCARE CENTERS INC
Entity Type:Organization
Organization Name:METRO PAVIA HEALTHCARE CENTERS INC
Other - Org Name:CIRUGIA AMB METROPAVIA CLINIC ARECIBO
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADALIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-650-0090
Mailing Address - Street 1:PO BOX 9976
Mailing Address - Street 2:COTTO STATION
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-9976
Mailing Address - Country:US
Mailing Address - Phone:787-650-0020
Mailing Address - Fax:787-650-0098
Practice Address - Street 1:CARR 129 INTERIOR
Practice Address - Street 2:ZONA INDUSTRIAL VICTOR ROJAS II
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-650-0090
Practice Address - Fax:787-650-0099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METRO PAVIA HEALTHCARE CENTERS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-01
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR33261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR33OtherSTATE LICENSE