| Kayada Corp | |
|
Pmb 136 Ave Alejandrino 3071 Guaynabo PR 00969-3071 | |
| (787) 269-8611 | |
| (787) 798-1224 |
| Full Name | Kayada Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | Pmb 136, Guaynabo, Puerto Rico |
| Authorized Official Name and Position | Luis Raul Forti (DUENO) |
| Authorized Official Contact | 7872698611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kayada Corp Pmb 136 Ave Alejandrino 3071 Guaynabo PR 00969-3071 Ph: (787) 269-8611 | Kayada Corp Pmb 136 Ave Alejandrino 3071 Guaynabo PR 00969-3071 Ph: (787) 269-8611 |
| NPI Number | 1831412527 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 03/09/2010 |
| Medicare PECOS PAC ID | 0042468670 |
|---|---|
| Medicare Enrollment ID | O20120924000430 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831412527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Luis R Forti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205923505 PECOS PAC ID: 8022185412 Enrollment ID: I20080926000497 |
| Provider Name | Javieth Detres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649404195 PECOS PAC ID: 7012168792 Enrollment ID: I20121105000597 |
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