Physician Healthcare Administration LLC

Organization Active NPI Emergency Medicine Physician · Arecibo, PR

NPI 1457730871 · NPPES record last updated May 21, 2015

Key facts

NPI
1457730871
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
License
18074 (PR)
Legal business name
PHYSICIAN HEALTHCARE ADMINISTRATION LLC
Practice address
Carr 129 KM 0.1
Ave San Luis
Arecibo, PR 00612
Phone
(787) 817-3030
NPI assigned
May 19, 2015
Organization subpart
No

Authorized official

Name
Dr. Lizbette Lugo, CSP
Title
Owner
Phone
(787) 817-3030

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160331000779 PR Part B Supplier - Clinic/Group Practice 5698072940 Receives reassigned benefits from 19 practitioners
Practice locations: Mayaguez, PR

National Provider Directory

Locations

H14 Calle 1
Vega Baja, PR 00693
Phone (787) 855-5493

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207P00000X 18074 PR Yes

Addresses

Primary practice location

Carr 129 KM 0.1
Ave San Luis
Arecibo, PR 00612

Mailing address

PO Box 140549
Arecibo, PR 00614-0549
Phone (787) 817-3030

Other providers in Arecibo, PR

All providers in Arecibo, PR · Emergency Medicine Physician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.