Provider Demographics
NPI:1962556159
Name:CENTRO MEDICINA FAMILIAR
Entity type:Organization
Organization Name:CENTRO MEDICINA FAMILIAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICO
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:GUILBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-869-8708
Mailing Address - Street 1:U11 CALLE LEILA ESTE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4618
Mailing Address - Country:US
Mailing Address - Phone:787-869-8708
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 152 KM 12 6
Practice Address - Street 2:BARRIO CEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-9336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X
PR261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Not Answered261Q00000XAmbulatory Health Care FacilitiesClinic/Center