Provider Demographics
NPI:1972748556
Name:MCP INTERNAL MEDICINE CLINIC & ASSOCIATES, P.S.C.
Entity type:Organization
Organization Name:MCP INTERNAL MEDICINE CLINIC & ASSOCIATES, P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PADILLA
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:MARIA DEL C
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-848-5194
Mailing Address - Street 1:206 TORRE SAN CRISTOBAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2847
Mailing Address - Country:US
Mailing Address - Phone:787-848-5194
Mailing Address - Fax:787-848-5194
Practice Address - Street 1:206 TORRE SAN CRISTOBAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2847
Practice Address - Country:US
Practice Address - Phone:787-848-5194
Practice Address - Fax:787-848-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D34221Medicare UPIN