Provider Demographics
NPI:1538557665
Name:GRUPO DE EMERGENCIAS VRC CSP
Entity type:Organization
Organization Name:GRUPO DE EMERGENCIAS VRC CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-509-8226
Mailing Address - Street 1:AMATISTA #5
Mailing Address - Street 2:BUCARE
Mailing Address - City:GUAYNABO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00969
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AMATISTA #5
Practice Address - Street 2:BUCARE
Practice Address - City:GUAYNABO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00969
Practice Address - Country:UM
Practice Address - Phone:787-509-8226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-23
Last Update Date:2014-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15668282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1558482638Medicare PIN