Healthcare Provider Details

I. General information

NPI: 1568527174
Provider Name (Legal Business Name): KYNTAN ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE FERNANDEZ GARCIA 107
LUQUILLO PR
00773
US

IV. Provider business mailing address

P.O. BOX 8219
CAGUAS PR
00726
US

V. Phone/Fax

Practice location:
  • Phone: 787-889-3360
  • Fax: 787-889-3664
Mailing address:
  • Phone: 787-744-7555
  • Fax: 787-747-3463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NAJEH YASSIN
Title or Position: GENERAL MANAGER
Credential:
Phone: 787-744-7455