Provider Demographics
NPI: | 1295579001 |
---|---|
Name: | CENIT MEDICAL CONSULTANTS LLC |
Entity type: | Organization |
Organization Name: | CENIT MEDICAL CONSULTANTS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | SASIDHAR |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GUTHIKONDA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 787-603-3883 |
Mailing Address - Street 1: | 285 PALMAS INN WAY, APT 2-101 |
Mailing Address - Street 2: | PALMANOVA VILLAGE, PALMAS DEL MAR |
Mailing Address - City: | HUMACAO |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00791 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-603-3883 |
Mailing Address - Fax: | |
Practice Address - Street 1: | ANEXO HOSPITAL RYDER, SUITE 105, #355 AVE. FONT MARTELO |
Practice Address - Street 2: | |
Practice Address - City: | HUMACAO |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00791 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-603-3883 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-06-25 |
Last Update Date: | 2024-11-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |