Provider Demographics
NPI:1699323691
Name:CENTRO ARARAT INC
Entity type:Organization
Organization Name:CENTRO ARARAT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-284-5884
Mailing Address - Street 1:PO BOX 7793
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7793
Mailing Address - Country:US
Mailing Address - Phone:787-284-5884
Mailing Address - Fax:787-651-3333
Practice Address - Street 1:60 CALLE DOMINGO RUBIO
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4473
Practice Address - Country:US
Practice Address - Phone:787-680-0236
Practice Address - Fax:787-816-5715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO ARARAT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-03
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty