Healthcare Provider Details

I. General information

NPI: 1336902717
Provider Name (Legal Business Name): ELAM GIOVANNY ROSSY MURATTI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE LAUREL
BAYAMON PR
00956-4816
US

IV. Provider business mailing address

361 CALLE GALILEO APT 5F
SAN JUAN PR
00927-4547
US

V. Phone/Fax

Practice location:
  • Phone: 787-787-5151
  • Fax:
Mailing address:
  • Phone: 787-231-7301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number38285-R
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: