Glossy

Specialty details in registry · San Juan, PR

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At a glance

Avenida Ponce De Leon, San Juan, PR 00907

NPPES record updated Aug 22, 2020. Public records can lag behind changes at a practice.

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Are you accepting new patients?
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Insurance participation and appointment availability are not established by these public records.

Practice location

Avenida Ponce De Leon # 653
San Juan, PR 00907

Professional details: NPI, taxonomy & registry record

NPI1790826030

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 3336C0003X
Enumeration date: Feb 9, 2007
Record updated: Aug 22, 2020

More registry details

Provider type: Organization · Type 2
Other reported name: <UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

3336C0003X · Primary

License reported: 07-F-1676 PR

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

Avenida Ponce De Leon
# 653
San Juan, PR 00907

Phone: (787) 764-2899

Mailing address

PO BOX 70250
SUITE 146
SAN JUAN, PR 00936

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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