Provider Demographics
NPI:1548671290
Name:CARIBE GERIATRICS AND INTERNAL MEDICINE, PSC
Entity type:Organization
Organization Name:CARIBE GERIATRICS AND INTERNAL MEDICINE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:MELECIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-270-0710
Mailing Address - Street 1:PO BOX 1775
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-1775
Mailing Address - Country:US
Mailing Address - Phone:787-270-0710
Mailing Address - Fax:787-270-4878
Practice Address - Street 1:1 CALLE MARGINAL
Practice Address - Street 2:204
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-6796
Practice Address - Country:US
Practice Address - Phone:787-270-0710
Practice Address - Fax:787-270-4878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11777207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG44962Medicare UPIN