MEDICARE: OPEN CARE WELLNESS CENTER MOBILE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	111N00000X	Chiropractor
3	133N00000X	Nutritionist
4	208D00000X	General Practice Physician
5	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician

General Provider Information

NPI Number	:	1073301404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN CARE WELLNESS CENTER MOBILE

Provider Business Mailing Address
First Line	:	5031 CALLE TINTILLO
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00966-1647
Country	:	US
Telephone Number	:	787-941-7272
Fax Number	:

Provider Business Practice Location Address
First Line	:	5031 CALLE TINTILLO
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00966-1647
Country	:	US
Telephone Number	:	787-941-7272
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUIS M MARTINEZ
Credential	:
Telephone Number	:	787-237-1412

Provider Enumeration Date	:	04/26/2025
Last Update Date	:	12/09/2025

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Directions to “OPEN CARE WELLNESS CENTER MOBILE ” Practice Location

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