Provider Demographics
NPI:1952092983
Name:CENTRO DE CUIDADOS PREVENTIVOS LAS VEGAS LLC
Entity type:Organization
Organization Name:CENTRO DE CUIDADOS PREVENTIVOS LAS VEGAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-318-3395
Mailing Address - Street 1:43 CALLE REAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-9014
Mailing Address - Country:US
Mailing Address - Phone:787-318-3395
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 688 BARRIO SABANA 377
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-369-6210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-19
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care