| NPI | 1114189594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESBIA C BETANCOURT Care Manager Supervisor 787-641-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: PR 3906) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: PR 3906) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2008-06-27 |