Provider Demographics
NPI:1346570207
Name:POLICLINICA DR. LUIS RODRIGUEZ CARRASQUILLO, PSC
Entity type:Organization
Organization Name:POLICLINICA DR. LUIS RODRIGUEZ CARRASQUILLO, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:OROZCO RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-752-7897
Mailing Address - Street 1:PO BOX 3762
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00984
Mailing Address - Country:UM
Mailing Address - Phone:787-752-7897
Mailing Address - Fax:787-768-0689
Practice Address - Street 1:CAMPO RICO ST . A6
Practice Address - Street 2:CASTELLANA GARDENS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-752-7897
Practice Address - Fax:787-768-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PREW424AMedicare PIN
PRE31222Medicare UPIN