Provider Demographics
NPI:1265623326
Name:HEALTH CARE FAMILY MANAGEMENT P.S.C.
Entity type:Organization
Organization Name:HEALTH CARE FAMILY MANAGEMENT P.S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MORALES
Authorized Official - Last Name:VAZQUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-915-5274
Mailing Address - Street 1:238 CALLE ALMENDRO
Mailing Address - Street 2:GRAND PALM II
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-2440
Mailing Address - Country:US
Mailing Address - Phone:787-915-5274
Mailing Address - Fax:
Practice Address - Street 1:238 CALLE ALMENDRO
Practice Address - Street 2:GRAND PALM II
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-2440
Practice Address - Country:US
Practice Address - Phone:787-915-5274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH CARE FAMILY MANAGEMENT P.S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15082302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI02903Medicare UPIN