Provider Demographics
NPI:1912172602
Name:PCR INTERNAL MEDICINE P.S.C.
Entity Type:Organization
Organization Name:PCR INTERNAL MEDICINE P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-779-8311
Mailing Address - Street 1:URBANIZACION SANTA JUANITA PMB 206
Mailing Address - Street 2:UU 1 CALLE 39
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-779-8311
Mailing Address - Fax:787-779-8311
Practice Address - Street 1:EXTENCION FOREST HILLS
Practice Address - Street 2:E 55 CALLE MARGINAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-779-8311
Practice Address - Fax:787-779-8311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11842174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH31920Medicare UPIN