Provider Demographics
NPI:1720072051
Name:AMERICAN TELEMEDICINE CENTER CORP.
Entity Type:Organization
Organization Name:AMERICAN TELEMEDICINE CENTER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZESAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZORBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-721-5424
Mailing Address - Street 1:URB. FLORAL PARK
Mailing Address - Street 2:62 CALLE JOSE MARTI
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3104
Mailing Address - Country:US
Mailing Address - Phone:787-721-5424
Mailing Address - Fax:787-721-5420
Practice Address - Street 1:URB FLORAL PARK
Practice Address - Street 2:62 CALLE JOSE MARTI
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3104
Practice Address - Country:US
Practice Address - Phone:787-721-5424
Practice Address - Fax:787-721-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-01
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4646207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR80293Medicare ID - Type UnspecifiedAMERICAN TELEMEDICINE
PR80293AMedicare ID - Type UnspecifiedAMERICAN TEL DR. COLON