Provider Demographics
NPI:1215675400
Name:INTEGRAL WELLNESS
Entity type:Organization
Organization Name:INTEGRAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH EDUCATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, ND
Authorized Official - Phone:787-462-8284
Mailing Address - Street 1:9 AVE MUNOZ RIVERA, ESQ CELIS AGUILERA
Mailing Address - Street 2:OFFICE 2 D
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-462-8284
Mailing Address - Fax:
Practice Address - Street 1:9 AVE MUNOZ RIVERA, ESQ CELIS AGUIL
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-0072
Practice Address - Country:US
Practice Address - Phone:787-462-8284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRAL WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-26
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1083825160OtherPROVATE INSURANCE
PR1083825160OtherMEDICARE PART B
PR1083825160Medicaid
PR1083825160OtherMEDICARE