Healthcare Provider Details

I. General information

NPI: 1912814716
Provider Name (Legal Business Name): DUO HEALTH OF PUERTO RICO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALLE TOMAS DAVILA
BARCELONETA PR
00617-2798
US

IV. Provider business mailing address

PO BOX 530322
ATLANTA GA
30353-0322
US

V. Phone/Fax

Practice location:
  • Phone: 305-697-8006
  • Fax:
Mailing address:
  • Phone: 305-697-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRYAN BECKER
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 814-470-3634