Provider Demographics
NPI:1649607854
Name:RECINTO DE CIENCIAS MEDICAS
Entity type:Organization
Organization Name:RECINTO DE CIENCIAS MEDICAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADM. ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISHBELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCEPCION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-758-2525
Mailing Address - Street 1:CIRUGIA ORAL Y MAXILOFACIAL
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-751-0808
Practice Address - Street 1:ESCUELA DE MEDICINA DENTAL RCM PISO 1 OFIC 128
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO, BO. MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00929-0134
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:787-751-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery