Provider Demographics
NPI:1962140202
Name:PROFESSIONAL EDUCATION CARE SERVICE CENTER
Entity type:Organization
Organization Name:PROFESSIONAL EDUCATION CARE SERVICE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:
Authorized Official - Last Name:LABOY COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:787-238-5152
Mailing Address - Street 1:PO BOX 372571
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-2571
Mailing Address - Country:US
Mailing Address - Phone:787-238-5152
Mailing Address - Fax:
Practice Address - Street 1:A6 CALLE 2 MANSIONES DE MONTESOL
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-238-5152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care