Provider Demographics
NPI:1659192250
Name:CARIBBEAN INTERVENTIONAL SPINE INSTITUTE LLC
Entity type:Organization
Organization Name:CARIBBEAN INTERVENTIONAL SPINE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAIN MEDICINE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CACERES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-218-0172
Mailing Address - Street 1:1395 CALLE SAN RAFAEL
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-2518
Mailing Address - Country:US
Mailing Address - Phone:787-941-2756
Mailing Address - Fax:
Practice Address - Street 1:1395 CALLE SAN RAFAEL
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2518
Practice Address - Country:US
Practice Address - Phone:787-941-2756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty