Provider Demographics
NPI:1104599570
Name:INTER AMERICAN UNIVERSITY OF PR BAYAMON CAMPUS
Entity type:Organization
Organization Name:INTER AMERICAN UNIVERSITY OF PR BAYAMON CAMPUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SERAFIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-279-1912
Mailing Address - Street 1:CARR. 500 DR. JOHN WILL HARRIS
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957-6257
Mailing Address - Country:US
Mailing Address - Phone:787-279-1912
Mailing Address - Fax:
Practice Address - Street 1:CARR. 500 DR. JOHN WILL HARRIS
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-0095
Practice Address - Country:US
Practice Address - Phone:787-279-1912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service