Provider Demographics
NPI:1861172876
Name:FPRM
Entity type:Organization
Organization Name:FPRM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:MAYMI-CASTRODAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-647-3682
Mailing Address - Street 1:100 PASEO SAN PABLO STE 410
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-7028
Mailing Address - Country:US
Mailing Address - Phone:787-780-0970
Mailing Address - Fax:787-780-1660
Practice Address - Street 1:100 PASEO SAN PABLO STE 410
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7028
Practice Address - Country:US
Practice Address - Phone:787-780-0970
Practice Address - Fax:787-780-1660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty