Healthcare Provider Details

I. General information

NPI: 1841742913
Provider Name (Legal Business Name): HEALTH INNOVATION SYSTEMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CALLE TABONUCO GAM TOWER SUITE 203 SAN PATRICIO
GUAYNABO PR
00968-3020
US

IV. Provider business mailing address

PO BOX 366279
SAN JUAN PR
00936-6279
US

V. Phone/Fax

Practice location:
  • Phone: 787-331-2020
  • Fax:
Mailing address:
  • Phone: 787-331-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ENRIQUE FERNANDO IRIZARRY
Title or Position: PRESIDENT
Credential:
Phone: 787-331-2020