Provider Demographics
NPI:1174705040
Name:CORPORACION PUERTORRIQUENA DE SALUD INTEGRAL
Entity type:Organization
Organization Name:CORPORACION PUERTORRIQUENA DE SALUD INTEGRAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:YAMIL
Authorized Official - Last Name:ABREU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-547-1382
Mailing Address - Street 1:52 CALLE MCKINLEY
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-5200
Mailing Address - Country:US
Mailing Address - Phone:787-637-0822
Mailing Address - Fax:787-650-2835
Practice Address - Street 1:137 CALLE DR CUETO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-2861
Practice Address - Country:US
Practice Address - Phone:787-637-0822
Practice Address - Fax:787-650-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16579261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service