Healthcare Provider Details

I. General information

NPI: 1629812433
Provider Name (Legal Business Name): XANARTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 06/25/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

URB BOSQUE DE LA SIERRA, CALLE COQUI GRILLO 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 TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIBEL GONZALEZ RUIZ
Title or Position: EXCECUTIVE DIRECTOR, CO-OWNER
Credential: FNP
Phone: 787-240-1755