Provider Demographics
NPI:1922320670
Name:CENTRO DE SERVICIOS MEDICOS DE LEVITTOWN, INC.
Entity Type:Organization
Organization Name:CENTRO DE SERVICIOS MEDICOS DE LEVITTOWN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-261-1005
Mailing Address - Street 1:PO BOX 51513
Mailing Address - Street 2:LEVITTOWN STATION
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1513
Mailing Address - Country:US
Mailing Address - Phone:787-795-2911
Mailing Address - Fax:787-784-0680
Practice Address - Street 1:HF16 CALLE LIZZIE GRAHAM
Practice Address - Street 2:SEPTIMA SECCION LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3634
Practice Address - Country:US
Practice Address - Phone:787-795-2911
Practice Address - Fax:787-784-0680
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALA DE EMERGENCIA CENTRO DE SERVICIOS MEDICOS DE LEVITTOWN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care