Provider Demographics
NPI:1205663952
Name:CAPCO MEDICAL INC
Entity type:Organization
Organization Name:CAPCO MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-429-3375
Mailing Address - Street 1:HC 7 BOX 34571
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9635
Mailing Address - Country:US
Mailing Address - Phone:787-400-5893
Mailing Address - Fax:
Practice Address - Street 1:107 CALLE DR CUETO LOCAL 1
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-400-5893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care