Centro de Evaluacion Y Terapia de Penuelas Inc

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

305962 Issued in PR

Legal business name

CENTRO DE EVALUACION Y TERAPIA DE PENUELAS INC

Practice address

710 Calle Amalia Marin
Penuelas, PR 00624-1719

Phone

(787) 836-5549

Fax

(787) 836-5549

NPI assigned

Apr 9, 2014

Last updated

Apr 9, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Angel Luis Pacheco

Title

President

Phone

(787) 836-5549

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1942629670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CALLE AMALIA MARIN",
            "city": "PENUELAS",
            "state": "PR",
            "postal_code": "006241719",
            "telephone_number": "787-836-5549",
            "fax_number": "787-836-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CALLE AMALIA MARIN",
            "city": "PENUELAS",
            "state": "PR",
            "postal_code": "006241719",
            "telephone_number": "787-836-5549",
            "fax_number": "787-836-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE EVALUACION Y TERAPIA DE PENUELAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-836-5549",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PR",
            "license": "305962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Penuelas, PR
• Providers in Penuelas, PR by specialty
• Health Maintenance Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.