| Corredor Azul Integral Llc | |
|
River Town Plaza 50 Ave Los Filtros, Bo. Juan Sanchez Bayamon PR 00969 | |
| (787) 378-9001 | |
| Not Available |
| Full Name | Corredor Azul Integral Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | River Town Plaza, Bayamon, Puerto Rico |
| Authorized Official Name and Position | Bernice Lopez (ADMINISTRATOR) |
| Authorized Official Contact | 7873789001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corredor Azul Integral Llc 105 Carr. 21 Bo. Monacillos, Suite 206 San Juan PR 00927 Ph: (787) 378-9001 | Corredor Azul Integral Llc River Town Plaza 50 Ave Los Filtros, Bo. Juan Sanchez Bayamon PR 00969 Ph: (787) 378-9001 |
| NPI Number | 1346097672 |
|---|---|
| Provider Enumeration Date | 05/03/2024 |
| Last Update Date | 03/07/2025 |
| Certification Date | 03/07/2025 |
| Medicare PECOS PAC ID | 0749700888 |
|---|---|
| Medicare Enrollment ID | O20250220000372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346097672 | NPI | - | NPPES |
| Provider Name | Jorge R De Jesus Miranda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376630202 PECOS PAC ID: 2466551296 Enrollment ID: I20070620000242 |
| Provider Name | Rafael A Burgos Calderon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1376653162 PECOS PAC ID: 9133215171 Enrollment ID: I20071022000577 |
| Provider Name | Brigida Y Colon Barreto |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1962989301 PECOS PAC ID: 6608276688 Enrollment ID: I20231212000000 |
| Provider Name | Marisel Vazquez Delgado |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265014328 PECOS PAC ID: 6103280649 Enrollment ID: I20240223003506 |
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