Centro Servicios Primarios de Salud de Patillas Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Patillas, PR
NPI 1275539728 · NPPES record last updated Mar 6, 2025
Key facts
- NPI
- 1275539728
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- CENTRO SERVICIOS PRIMARIOS DE SALUD DE PATILLAS INC.
- Practice address
- 99 Guillermo Riefkohl St.
Patillas, PR 00723-0000 - Phone
- (787) 839-4320
- Fax
- (787) 271-0004
- NPI assigned
- Jun 21, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mildred Morel, BBA
- Title
- Executive Director
- Phone
- (787) 839-4320
Other NPIs on the same Medicare enrollment 3
Corporate family (same tax ID) 13
Practitioners 42
-
Rafael Acevedo Soto, M.D.
-
Anthony Agosto, MD
-
Karla M Figueroa Colon, M.D.
-
Arturo Tomas Garcia, M.D.
-
Antonio Lozada, MD
-
Mirella Rodriguez, M.D.
-
Waldemar Trinidad, M.D.
-
Samuel Cruz Estrada, M.D.
-
Araceli De Jesus-Burgos, M.D.
-
Mariam Feliciano, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070718000259 | PR | Part B Supplier - Clinic/Group Practice | 7012018211 |
Receives reassigned benefits from 40 practitioners 3 other NPIs on this enrollment Practice locations: Maunabo, PR; Santa Isabel, PR; Salinas, PR; Patillas, PR |
National Provider Directory
- Tax ID family
- Centro de Servicios Primarios de Salud de Patillas Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
99 Guillermo Riefkohl St.
Patillas, PR 00723-0000
Mailing address
99 Guillermo Riefkhol Street
PO Box 697
Patillas, PR 00723-0697
Phone (787) 839-4320
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0080082 | Other | PTAN |
Other providers in Patillas, PR
- Ana Diaz Cautino
- Centro de Diagnostico Y Tratamiento Patillas
- Centro de Servicios Primarios de Salud de Patillas Inc.
- Centro de Servicios Promarios de Salud de Patillas Inc.
- Centro Servicios Primarios de Salud de Patillas Inc.
- Centro Servicios Primarios de Salud de Patillas Inc.
- Centro Servicios Primarios de Salud de Patillas Inc.
- Centro Servicios Primarios de Salud de Patillas Inc.
- Changri-la Resort, Inc.
- Yahaira Cintron-Perez
All providers in Patillas, PR · Federally Qualified Health Center (FQHC) in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.