Provider Demographics
NPI:1841313442
Name:CENTRO DE REUMATOLOGIA PEDIATRICA DE PUERTO RICO
Entity type:Organization
Organization Name:CENTRO DE REUMATOLOGIA PEDIATRICA DE PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:I
Authorized Official - Last Name:QUINTERO DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:787-726-1113
Mailing Address - Street 1:PO BOX 9066312
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00906-6312
Mailing Address - Country:US
Mailing Address - Phone:787-726-1113
Mailing Address - Fax:
Practice Address - Street 1:252 CALLE CONVENTO
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00912-3207
Practice Address - Country:US
Practice Address - Phone:787-726-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric RheumatologyGroup - Single Specialty