Provider Demographics
NPI:1609652973
Name:CLINICA DE MEDICINA INTERNA PR LLC
Entity type:Organization
Organization Name:CLINICA DE MEDICINA INTERNA PR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-675-1010
Mailing Address - Street 1:PO BOX 2117
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2117
Mailing Address - Country:US
Mailing Address - Phone:787-675-1010
Mailing Address - Fax:
Practice Address - Street 1:E50 CALLE MARGINAL
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5513
Practice Address - Country:US
Practice Address - Phone:787-675-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care