Provider Demographics
NPI:1780940528
Name:MUNICIPIO DE LAS PIEDRAS
Entity type:Organization
Organization Name:MUNICIPIO DE LAS PIEDRAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-733-8969
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0068
Mailing Address - Country:US
Mailing Address - Phone:787-733-8969
Mailing Address - Fax:787-716-0055
Practice Address - Street 1:CARR 198 KM 22.2
Practice Address - Street 2:BO. MONTONES 1
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-733-8969
Practice Address - Fax:787-716-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR12-023OtherCNC
PR28OtherLIC