Healthcare Provider Details

I. General information

NPI: 1225992712
Provider Name (Legal Business Name): DR BODY TRUTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 63 #123-1 CENTRO VACUNACION CAROLINA Y DRA LUCY MUNDO
CAROLINA PR
00985
US

IV. Provider business mailing address

305 AVE LAURO PINERO UNIT 1231
CEIBA PR
00735-2872
US

V. Phone/Fax

Practice location:
  • Phone: 787-238-6916
  • Fax:
Mailing address:
  • Phone: 787-238-6916
  • Fax: 787-238-6916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KATIA NATASHA MILLER PAGAN
Title or Position: CHIEF EXECUTIVE MANAGER
Credential: MD
Phone: 787-238-6916