Provider Demographics
NPI:1992140685
Name:CENTRO SALUD SUSANA CENTENO VIEQUES
Entity type:Organization
Organization Name:CENTRO SALUD SUSANA CENTENO VIEQUES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISORA FCATURACION
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-741-0392
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:BO. DESTINO
Mailing Address - City:VIEQUES
Mailing Address - State:PR
Mailing Address - Zip Code:00765
Mailing Address - Country:US
Mailing Address - Phone:787-741-0392
Mailing Address - Fax:
Practice Address - Street 1:CARR 997 K1 H1
Practice Address - Street 2:
Practice Address - City:VIEQUES
Practice Address - State:PR
Practice Address - Zip Code:00765
Practice Address - Country:US
Practice Address - Phone:787-741-0392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center