Healthcare Provider Details

I. General information

NPI: 1831503747
Provider Name (Legal Business Name): METRO PAVIA AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 METROPOLITAN OFFICE BUILDING AVE JOSE DE DIEGO SUITE 205
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 11938
SAN JUAN PR
00922-1938
US

V. Phone/Fax

Practice location:
  • Phone: 787-817-0498
  • Fax:
Mailing address:
  • Phone: 787-817-0498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SIOMARA PIMENTEL
Title or Position: ADMINISTRADORA
Credential:
Phone: 787-829-4453