Provider Demographics
NPI:1184014540
Name:CLINICA DE MEDICINA ESPECIALIZADA C.S.P.
Entity type:Organization
Organization Name:CLINICA DE MEDICINA ESPECIALIZADA C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO-DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-440-0114
Mailing Address - Street 1:PO BOX 2360
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2360
Mailing Address - Country:US
Mailing Address - Phone:939-440-0114
Mailing Address - Fax:787-680-7814
Practice Address - Street 1:PR-140, KM. 57.4
Practice Address - Street 2:BO. SAN AGUSTIN
Practice Address - City:FLORIDA
Practice Address - State:PR
Practice Address - Zip Code:00650-0000
Practice Address - Country:US
Practice Address - Phone:939-440-0114
Practice Address - Fax:787-680-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care