Provider Demographics
NPI:1669732517
Name:QUEBRADILLAS HEALTH CARE CENTER PSC
Entity type:Organization
Organization Name:QUEBRADILLAS HEALTH CARE CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-895-6315
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0938
Mailing Address - Country:US
Mailing Address - Phone:787-895-6315
Mailing Address - Fax:
Practice Address - Street 1:CALLE MUNOS RIVERA 141 ESQUINASAN JUSTO
Practice Address - Street 2:
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-0988
Practice Address - Country:US
Practice Address - Phone:787-895-6315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty