Healthcare Provider Details

I. General information

NPI: 1053156232
Provider Name (Legal Business Name): XANARTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2024
Last Update Date: 06/28/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. PEDRO ALBIZU CAMPOS, URB. LA HACIENDA HOSPITAL MENONITA DE GUAYAMA SUITE 301
GUAYAMA PR
00784
US

IV. Provider business mailing address

URB BOSQUES DE LA SIERRA 1004
CAGUAS PR
00725
US

V. Phone/Fax

Practice location:
  • Phone: 787-558-7038
  • Fax:
Mailing address:
  • Phone: 787-240-1755
  • Fax:

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 Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM RODRIGUEZ ZAYAS
Title or Position: INTERNIST
Credential: MD
Phone: 787-204-0308