Healthcare Provider Details

I. General information

NPI: 1407775265
Provider Name (Legal Business Name): CENTRO DE MEDICINA NATURAL Y REGENERATIVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE PARQUE
BAYAMON PR
00961-6218
US

IV. Provider business mailing address

PO BOX 615
COROZAL PR
00783-0615
US

V. Phone/Fax

Practice location:
  • Phone: 787-649-9593
  • Fax:
Mailing address:
  • Phone: 787-649-9593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JUAN ALBERTO MORENO PADILLA
Title or Position: MD
Credential: MD
Phone: 787-649-9596