Provider Demographics
NPI:1194228304
Name:ELITE PULMONARY CARE CENTER PSC
Entity type:Organization
Organization Name:ELITE PULMONARY CARE CENTER PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA DEL MAR
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-643-5075
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0203
Mailing Address - Country:US
Mailing Address - Phone:787-630-2353
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 TORRE MEDICA SAN VICENTE DE PAUL
Practice Address - Street 2:OFICINA 402
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-630-2353
Practice Address - Fax:787-254-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17669207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty