Provider Demographics
NPI:1912282914
Name:INTEGRATE MEDICAL CARE, INC.
Entity Type:Organization
Organization Name:INTEGRATE MEDICAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CANDELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-778-3394
Mailing Address - Street 1:PO BOX 6598
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5598
Mailing Address - Country:US
Mailing Address - Phone:787-778-3394
Mailing Address - Fax:787-778-0330
Practice Address - Street 1:20 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6906
Practice Address - Country:US
Practice Address - Phone:787-778-0315
Practice Address - Fax:787-778-0330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization