Provider Demographics
NPI:1962651497
Name:CCALA CORP
Entity type:Organization
Organization Name:CCALA CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAMIREZ-BUSIGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-413-4375
Mailing Address - Street 1:VILLA CAPARRA, 26 CALLE J
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2202
Mailing Address - Country:US
Mailing Address - Phone:787-413-4375
Mailing Address - Fax:787-783-5007
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:SUITE #301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-413-4375
Practice Address - Fax:787-783-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical