Healthcare Provider Details

I. General information

NPI: 1164357307
Provider Name (Legal Business Name): MEDWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

C1 CALLE A URB. JARDINES DE LAFAYETTE
ARROYO PR
00714
US

IV. Provider business mailing address

URB. JARDINES DE LAFAYETTE B6 CALLE G
ARROYO PR
00714
US

V. Phone/Fax

Practice location:
  • Phone: 939-250-8389
  • Fax:
Mailing address:
  • Phone: 939-250-8389
  • 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: RAFAEL SANTIAGO BORRAS
Title or Position: PRESIDENT
Credential: MD
Phone: 939-250-8389