Organization
POLICLINICA SAN PEDRO PSC
Active
Other names
CDT POLICLINICA SAN PEDRO
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA C RIVERA IRIZARRY (ADMINISTRATOR)
(787) 839-3980
Entity
Organization
Contact information
Practice address
211 CALLE MORSE, ARROYO, PR 00714-2350
(787) 839-3980
(787) 271-2515
Mailing address
PO BOX 818, ARROYO, PR 00714-0818
(787) 839-3980
(787) 271-2515
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
229
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HV265A
MEDICARE PTAN
PR
Enumeration date
11/17/2005
Last updated
09/19/2017
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