Provider Demographics
NPI: | 1972120897 |
---|---|
Name: | CLINICA TODO SALUD - AIBONITO LLC |
Entity type: | Organization |
Organization Name: | CLINICA TODO SALUD - AIBONITO LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER REGIONAL CLINICAL OPERATION |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHEILLY |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | PEREZ FELIX |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MHSA |
Authorized Official - Phone: | 787-226-5234 |
Mailing Address - Street 1: | PO BOX 70105 |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN JUAN |
Mailing Address - State: | PR |
Mailing Address - Zip Code: | 00936-8014 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 787-545-7073 |
Mailing Address - Fax: | 787-620-5379 |
Practice Address - Street 1: | CARR 725 KM 0.5 BO LLANOS |
Practice Address - Street 2: | PARQUE INDUSTRIAL L-238-0-61 |
Practice Address - City: | AIBONITO |
Practice Address - State: | PR |
Practice Address - Zip Code: | 00705-3526 |
Practice Address - Country: | US |
Practice Address - Phone: | 787-545-7073 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-06-26 |
Last Update Date: | 2025-04-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QE0002X | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | Group - Multi-Specialty |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology |