Healthcare Provider Details

I. General information

NPI: 1790301984
Provider Name (Legal Business Name): CLINICA TODO SALUD - AIBONITO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 725 KM 0.5 BO LLANOS PARQUE INDUSTRIAL L-238-0-61
AIBONITO PR
00705-3526
US

IV. Provider business mailing address

PO BOX 70105
SAN JUAN PR
00936-8014
US

V. Phone/Fax

Practice location:
  • Phone: 787-545-7073
  • Fax:
Mailing address:
  • Phone: 787-545-7073
  • Fax: 787-620-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCOS AGUILA SASTRE
Title or Position: VP OF CLINICS
Credential: MHSA
Phone: 787-622-3000