Provider Demographics
NPI:1780940924
Name:PR HEALTHCARE MANAGEMENT GROUP
Entity type:Organization
Organization Name:PR HEALTHCARE MANAGEMENT GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-637-6274
Mailing Address - Street 1:B13 CALLE B
Mailing Address - Street 2:URB LAS VILLAS TOWNHOUSES
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3261
Mailing Address - Country:US
Mailing Address - Phone:787-637-6274
Mailing Address - Fax:787-874-1825
Practice Address - Street 1:B13 CALLE B
Practice Address - Street 2:URB LAS VILLAS TOWNHOUSES
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3261
Practice Address - Country:US
Practice Address - Phone:787-637-6274
Practice Address - Fax:787-874-3125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR246X00000X, 261QR0200X, 261QH0100X
261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service