| Organization Name: | CENTRO SERVICIOS PRIMARIOS DE SALUD DE PATILLAS INC. |
| NPI Number: | 1366654337 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MILDRED MOREL ORTIZ (EXECUTIVE DIRECTOR) |
| Mailing Address: | 99 Guillermo Riefkhol Street Patillas |
| State: | PR US |
| Postal Code: | 007230697 |
| Phone Number: | 7878394320 |
| Fax Number: | 7872710004 |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 55 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |