Provider Demographics
NPI:1205516366
Name:EMERGE PBC
Entity type:Organization
Organization Name:EMERGE PBC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPOS RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD MSC MBA
Authorized Official - Phone:787-436-8857
Mailing Address - Street 1:PO BOX 70344
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8344
Mailing Address - Country:US
Mailing Address - Phone:939-330-1109
Mailing Address - Fax:866-379-9205
Practice Address - Street 1:869 AVE MUNOZ RIVERA STE 303
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-2103
Practice Address - Country:US
Practice Address - Phone:939-330-1109
Practice Address - Fax:866-379-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No2080B0002XAllopathic & Osteopathic PhysiciansPediatricsObesity MedicineGroup - Multi-Specialty
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch