Healthcare Provider Details

I. General information

NPI: 1699734343
Provider Name (Legal Business Name): L.I.P.HEALTH SERVICES,CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB.VILLAS DE PLAN BONITO CARR.100 INT.KM.2.7 THE SAME
CABO ROJO PR
00623-0409
US

IV. Provider business mailing address

PO BOX 409 P.O.BOX 409 CABO ROJO,PUERTO RICO00623-0409
CABO ROJO PR
00623-0409
US

V. Phone/Fax

Practice location:
  • Phone: 787-851-9361
  • Fax: 787-851-9361
Mailing address:
  • Phone: 787-851-9361
  • Fax: 787-851-9361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number12607
License Number StatePR

VIII. Authorized Official

Name: DR. LUIS PINEIRO MONTALVO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 787-851-9361