Provider Demographics
NPI:1053540658
Name:WRIENTERPRISESCORP
Entity type:Organization
Organization Name:WRIENTERPRISESCORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WALDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-649-6042
Mailing Address - Street 1:32 CALLE TERRAZO
Mailing Address - Street 2:ESTANCIAS DE SAN NICOLAS
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-9042
Mailing Address - Country:US
Mailing Address - Phone:787-649-6042
Mailing Address - Fax:
Practice Address - Street 1:32 CALLE TERRAZO
Practice Address - Street 2:ESTANCIAS DE SAN NICOLAS
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692-9042
Practice Address - Country:US
Practice Address - Phone:787-649-6042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty