Healthcare Provider Details
I. General information
NPI: 1447780929
Provider Name (Legal Business Name): PLAZA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2017
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
AVE SANTA ANA #262 CENTRO COMERCIAL PLAZA ALTA MALL
BAYAMON PR
00957
US
IV. Provider business mailing address
PO BOX 8949
CAROLINA PR
00988-8949
US
V. Phone/Fax
- Phone: 787-620-9605
- Fax: 787-790-6720
- Phone: 787-717-5566
- Fax: 787-474-6210
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AWAD
YASSIN
Title or Position: PRESIDENT
Credential:
Phone: 787-717-5566