# INSTITUTO MEDICO DE CIALES, CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124256813
- **Authorized official:** DR. MARIA DE LOS ANGELES COLLAZO M.D (PRESIDENT)
- **Authorized official phone:** (787) 871-1146

## Contact information

- **Practice address:** 25 CALLE JOSE DE DIEGO, CIALES, PR 00638-3229
- **Practice address phone:** (787) 871-1146
- **Practice address fax:** (787) 871-1207
- **Mailing address:** 25 CALLE JOSE DE DIEGO, CIALES, PR 00638-3229
- **Mailing address phone:** (787) 871-1146
- **Mailing address fax:** (787) 871-1207

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 9227 | PR | Yes |
| 261QI0500X | Infusion Therapy Clinic/Center | 9227 | PR | — |
| 261QP2000X | Physical Therapy Clinic/Center | 9227 | PR | — |
| 261QP3300X | Pain Clinic/Center | 9227 | PR | — |
| 261QR1100X | Research Clinic/Center | 9227 | PR | — |

## Other

- **Enumeration date:** 07/01/2009
- **Last updated:** 07/01/2009