Provider Demographics
NPI:1740475300
Name:INSTHEMATONCOMEDICA
Entity type:Organization
Organization Name:INSTHEMATONCOMEDICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ-GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-250-7338
Mailing Address - Street 1:PO BOX 9021257
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-1257
Mailing Address - Country:US
Mailing Address - Phone:787-250-7338
Mailing Address - Fax:787-767-8342
Practice Address - Street 1:400 F.D. ROOSEVELT AVE.
Practice Address - Street 2:SUITE 409
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2710
Practice Address - Country:US
Practice Address - Phone:787-250-7338
Practice Address - Fax:787-767-8342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR12927OtherSSS ID NUMBER