Centro Clinico de Vega Alta Corp

Key facts

NPI: 1811249840
Entity type: Organization (NPI type 2)
Primary specialty: Family Medicine Physician 207Q00000X
Legal business name: CENTRO CLINICO DE VEGA ALTA CORP
Practice address: Calle Munoz Rivera Num 5a
Vega Alta, PR 00692
Phone: (787) 883-5917
NPI assigned: Oct 15, 2012
Organization subpart: No

Authorized official

Name: Maritza Trinidad Reyes, MD NPI 1265456040
Title: President
Phone: (787) 617-6141

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

Maritza Trinidad Reyes, MD Geriatric Medicine (Family Medicine) Physician · Rio Piedras, PR · NPI 1265456040

Medicare reassignment Authorized official PR
Marilu Trinidad- Menendez, PSY.D. Clinical Psychologist · Caguas, PR · NPI 1962773895

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20150616000869	PR	Part B Supplier - Clinic/Group Practice	0648581710	Receives reassigned benefits from 1 practitioner Practice locations: Vega Alta, PR

National Provider Directory

Locations

138 Ave Winston Churchill
#641
San Juan, PR 00926

5C Calle Munoz Rivera
Vega Alta, PR 00692
Phone (787) 270-4838

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician Group: 193200000X MULTI-SPECIALTY GROUP	207Q00000X			Yes

Addresses

Primary practice location

Calle Munoz Rivera Num 5a
Vega Alta, PR 00692

Mailing address

138 Winston Churchill Avenue
El Senorial Mail Station 641
San Juan, PR 00926
Phone (787) 883-5917

Other providers in Vega Alta, PR

All providers in Vega Alta, PR · Family Medicine Physician 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 Aug 21, 2014. 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.

Verify at the official NPI Registry.