Provider Demographics
NPI:1063804680
Name:CENTRO ONCOLOGICO DE CAYEY L.L.C.
Entity type:Organization
Organization Name:CENTRO ONCOLOGICO DE CAYEY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-214-5921
Mailing Address - Street 1:HC 73 BOX 6440
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9529
Mailing Address - Country:US
Mailing Address - Phone:787-214-5921
Mailing Address - Fax:
Practice Address - Street 1:HC 73 BOX 6440
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-9529
Practice Address - Country:US
Practice Address - Phone:787-214-5921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17646261QX0200X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncologyGroup - Multi-Specialty