Healthcare Provider Details

I. General information

NPI: 1952241762
Provider Name (Legal Business Name): MAS SALUD IV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ULISES MARTINEZ
HUMACAO PR
00791
US

IV. Provider business mailing address

PO BOX 1168
MAUNABO PR
00707-1168
US

V. Phone/Fax

Practice location:
  • Phone: 787-371-5070
  • Fax:
Mailing address:
  • Phone: 787-371-5070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIEMAR MORALES CORREA
Title or Position: MANAGING MEMBER
Credential:
Phone: 787-371-5070