Healthcare Provider Details

I. General information

NPI: 1356147904
Provider Name (Legal Business Name): CLINICA TERAPEUTICA ESTRELLAS EN CRECIMIENTO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7118 AVE AGUSTIN RAMOS CALERO
ISABELA PR
00662
US

IV. Provider business mailing address

URB. VILLA LINDA CALLE TORTOLA 435
AGUADILLA PR
00603
US

V. Phone/Fax

Practice location:
  • Phone: 939-633-0141
  • Fax:
Mailing address:
  • Phone: 939-633-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MISS AIDA FELICIANO
Title or Position: ATO
Credential:
Phone: 939-633-0141