Provider Demographics
NPI:1588940076
Name:RECINTO DE CIENCIAS MEDICAS
Entity type:Organization
Organization Name:RECINTO DE CIENCIAS MEDICAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:787-754-9165
Mailing Address - Street 1:PO BOX 29134
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:787-247-8156
Practice Address - Street 1:RCM EDIF. PRINCIPAL 3ER PISO
Practice Address - Street 2:CENTRO MEDICO DE PUERTO RICO, BO. MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00935
Practice Address - Country:US
Practice Address - Phone:787-766-0728
Practice Address - Fax:787-274-8156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR207ZP0105X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR32OtherPPMI - GROUP