Provider Demographics
NPI:1205979838
Name:RECETA A SU PUERTA INC.
Entity type:Organization
Organization Name:RECETA A SU PUERTA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZULEIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDO PADRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-751-6312
Mailing Address - Street 1:CALLE ROBLE #251 BO. CAPETILLO
Mailing Address - Street 2:
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00925-0000
Mailing Address - Country:US
Mailing Address - Phone:787-765-1211
Mailing Address - Fax:787-765-1576
Practice Address - Street 1:CALLE ROBLE # 251 BO. CAPETILLO
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00925
Practice Address - Country:UM
Practice Address - Phone:787-765-1211
Practice Address - Fax:787-765-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR08F2389302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization