Provider Demographics
NPI:1780888057
Name:POLICLINICA MEDICA FAMILIAR DE QUEBRADILLAS, C.S.P.
Entity type:Organization
Organization Name:POLICLINICA MEDICA FAMILIAR DE QUEBRADILLAS, C.S.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDRIK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-216-8453
Mailing Address - Street 1:CARR NUM 2 6429
Mailing Address - Street 2:PMB 48
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR NUM 2 KM 96.8
Practice Address - Street 2:BO COCOS
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-216-8453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care