Provider Demographics
NPI:1285361220
Name:INFINITY WELLNESS SOLUTIONS LLC
Entity type:Organization
Organization Name:INFINITY WELLNESS SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-202-8958
Mailing Address - Street 1:151 CALLE DE SAN FRANCISCO
Mailing Address - Street 2:STE 200 PMB 0919
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00901-1607
Mailing Address - Country:US
Mailing Address - Phone:470-202-8958
Mailing Address - Fax:888-201-5943
Practice Address - Street 1:151 CALLE DE SAN FRANCISCO
Practice Address - Street 2:STE 200 PMB 0919
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-1607
Practice Address - Country:US
Practice Address - Phone:470-202-8958
Practice Address - Fax:888-201-5943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center