Provider Demographics
NPI:1962049510
Name:CLINICA LAS AMERICAS GUAYNABO
Entity type:Organization
Organization Name:CLINICA LAS AMERICAS GUAYNABO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTINEZ RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPA MHSA
Authorized Official - Phone:787-999-3063
Mailing Address - Street 1:PO BOX 7891
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-789-1996
Mailing Address - Fax:
Practice Address - Street 1:201 SABANETAS IND PK
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4401
Practice Address - Country:US
Practice Address - Phone:787-789-1996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICA LAS AMERICAS GUAYNABO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-03
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty