Provider Demographics
NPI:1962712075
Name:MUNICIPIO DE SAN JUAN
Entity type:Organization
Organization Name:MUNICIPIO DE SAN JUAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRABAJADOR SOCIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:RAQUEL
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:4953
Authorized Official - Phone:787-480-3792
Mailing Address - Street 1:CALLE CERRA
Mailing Address - Street 2:
Mailing Address - City:SANTURCE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00907
Mailing Address - Country:UM
Mailing Address - Phone:787-480-3792
Mailing Address - Fax:787-723-6247
Practice Address - Street 1:#906 CALLE CERRA
Practice Address - Street 2:
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-480-3792
Practice Address - Fax:787-723-6247
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRO DE SALUD DR. GUALBERTO RABELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5943261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care