Provider Demographics
NPI:1174310338
Name:CLINICA INTEGRATIVA DE MEDICINA Y ACUPUNTURA LLC
Entity type:Organization
Organization Name:CLINICA INTEGRATIVA DE MEDICINA Y ACUPUNTURA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHED RICHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-225-7416
Mailing Address - Street 1:J6 AVE SAN PATRICIO APT 16E
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-4426
Mailing Address - Country:US
Mailing Address - Phone:787-225-7416
Mailing Address - Fax:
Practice Address - Street 1:68 CLL SANTA CRUZ, STE 504
Practice Address - Street 2:TORRE SAN PABLO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-225-7416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty