Provider Demographics
NPI:1962863159
Name:HEALTH AND WELLNESS NETWORK OF THE AMERICAS, LLC
Entity type:Organization
Organization Name:HEALTH AND WELLNESS NETWORK OF THE AMERICAS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-237-1093
Mailing Address - Street 1:CLINICA LAS AMERICAS
Mailing Address - Street 2:SUITE 104 400 FD ROOSEVELT
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2103
Mailing Address - Country:US
Mailing Address - Phone:787-250-5055
Mailing Address - Fax:
Practice Address - Street 1:CLINICA LAS AMERICAS
Practice Address - Street 2:SUITE 104 400 FD ROOSEVELT
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-250-5055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty