Provider Demographics
NPI:1174170765
Name:LIGA PUERTORRIQUENA CONTRA EL CANCER
Entity type:Organization
Organization Name:LIGA PUERTORRIQUENA CONTRA EL CANCER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YARISIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CENTENO SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-765-2382
Mailing Address - Street 1:PO BOX 191811
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-1811
Mailing Address - Country:US
Mailing Address - Phone:787-765-2382
Mailing Address - Fax:787-751-7940
Practice Address - Street 1:150 AVE AMERICO MIRANDA
Practice Address - Street 2:CENTRO MEDICO - BO MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-652-2382
Practice Address - Fax:787-751-7940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center