Provider Demographics
NPI:1386613446
Name:POLICLINICA LAS AMERICAS MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:POLICLINICA LAS AMERICAS MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:S
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-842-8945
Mailing Address - Street 1:PMB 281
Mailing Address - Street 2:AVE MUNOZ RIVERA 1575
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-0211
Mailing Address - Country:US
Mailing Address - Phone:787-842-8945
Mailing Address - Fax:787-290-4472
Practice Address - Street 1:2015 BLVD LUIS A FERRE STE 101
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0798
Practice Address - Country:US
Practice Address - Phone:787-842-8945
Practice Address - Fax:787-290-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1386613446OtherHUMANA HEALTH PLANS OF PUERTO RICO
PR1386613446OtherMSO OF PUERTO RICO LLC
PR1386613446OtherFIRST MEDICAL HEALTH PLAN, INC.
PR1386613446OtherTRIPLE S, SALUD
PR1386613446OtherMOLINA HEALTHCARE OF PUERTO RICO
PR1386613446OtherASOCIACION DE MAESTROS DE PR