Provider Demographics
NPI:1932264975
Name:CENTRO CITOPATOLOGICO DEL CARIBE, INC.
Entity Type:Organization
Organization Name:CENTRO CITOPATOLOGICO DEL CARIBE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLANUEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-759-7822
Mailing Address - Street 1:PO BOX 364747
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-4747
Mailing Address - Country:US
Mailing Address - Phone:787-759-7822
Mailing Address - Fax:787-759-8887
Practice Address - Street 1:CONDOMINIO EL CENTRO II LOCAL 21
Practice Address - Street 2:AVE. MUNOZ RIVERA 500
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-759-7822
Practice Address - Fax:787-759-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR899B207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83502Medicare ID - Type Unspecified