Healthcare Provider Details

I. General information

NPI: 1922883560
Provider Name (Legal Business Name): HOLISTIC CARE VETERANS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URBANIZACION TORRE ALTA NO. 21
PUERTO PLATA DOMINICAN REPUBLIC
57000
DO

IV. Provider business mailing address

PO BOX 60183
FORT MYERS FL
33906-6183
US

V. Phone/Fax

Practice location:
  • Phone: 809-858-8142
  • Fax:
Mailing address:
  • Phone: 239-230-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUNIOR PEREZ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 809-858-8142