Provider Demographics
NPI:1952075434
Name:CENTRO DE ALERGIA E INMUNOLOGIA LLC
Entity Type:Organization
Organization Name:CENTRO DE ALERGIA E INMUNOLOGIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YANIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-336-7476
Mailing Address - Street 1:PO BOX 9545
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9545
Mailing Address - Country:US
Mailing Address - Phone:939-336-7476
Mailing Address - Fax:939-336-7475
Practice Address - Street 1:1728 CALLE SEGRE
Practice Address - Street 2:URB. RIO PIEDRAS HEIGHTS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:939-336-7476
Practice Address - Fax:939-336-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty