Provider Demographics
NPI:1962949156
Name:CFSE-OFICINA REGIONAL CAGUAS
Entity type:Organization
Organization Name:CFSE-OFICINA REGIONAL CAGUAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-746-2010
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0425
Mailing Address - Country:US
Mailing Address - Phone:787-746-2010
Mailing Address - Fax:787-745-2228
Practice Address - Street 1:AVE LUIS MUNOZ MARIN EDIFICIO MERCANTIL CAGUAX
Practice Address - Street 2:URB SANTA JUANA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0425
Practice Address - Country:US
Practice Address - Phone:787-746-2010
Practice Address - Fax:787-745-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR117261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local