Healthcare Provider Details
I. General information
NPI: 1245152537
Provider Name (Legal Business Name): XRV LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CALLE J #9 EXTENSION HERMANAS DAVILA
BAYAMON PR
00959-6057
US
IV. Provider business mailing address
75 PLAZA 8 URB GRANVISTA 2
GURABO PR
00778-5057
US
V. Phone/Fax
- Phone: 787-854-3322
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
XIOMARA
RESTO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-999-9999