Provider Demographics
NPI:1831343276
Name:SECCION A NINOS CON NECESIDADES ESPECIALES DE SALUD
Entity type:Organization
Organization Name:SECCION A NINOS CON NECESIDADES ESPECIALES DE SALUD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA EJECUTIVA
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:787-771-2100
Mailing Address - Street 1:CENTRO PEDIATRICO DE ARECIBO VACUNACION
Mailing Address - Street 2:AVENIDA SAN LUIS # 621
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-3666
Mailing Address - Country:US
Mailing Address - Phone:787-817-1245
Mailing Address - Fax:787-879-9026
Practice Address - Street 1:CENTRO PEDIATRICO DE ARECIBO VACUNACION
Practice Address - Street 2:AVENIDA SAN LUIS # 621
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00616-3666
Practice Address - Country:US
Practice Address - Phone:787-817-1245
Practice Address - Fax:787-879-9026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO DE VACUNACION DE ARECIBO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR060524OtherMED
PR660433481-1YOtherTERAPISTA
PR6120147OtherMEDICO
PRS012OtherFISIOTERAPIA
PR3511863OtherMED Y TERAPIATAS
PR660433481-1GOtherGENTICISTA
PRS011OtherPEDIATRA
PRSH-10001OtherMED
PRSH-10001OtherMED