Healthcare Provider Details
I. General information
NPI: 1629989538
Provider Name (Legal Business Name): MAX HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PRADERAS DE NAVARRO SHOPPING CENTER CARR. 931 KM 5.4 SECTOR CIELITO
GURABO PR
00778
US
IV. Provider business mailing address
PRADERAS DE NAVARRO SHOPPING CENTER CARR. 931 KM 5.4 SECTOR CIELITO
GURABO PR
00778
US
V. Phone/Fax
- Phone: 939-342-6054
- Fax:
- Phone: 939-342-6054
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEX
CARRASQUILLO VILLANUEVA
Title or Position: ADMINISTRATOR
Credential:
Phone: 939-342-6054