Healthcare Provider Details

I. General information

NPI: 1437659349
Provider Name (Legal Business Name): PREVENTIVE MANAGEMENT SYSTEM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2018
Last Update Date: 02/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 3 B24 URB FLAMBOYAN
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 77
MANATI PR
00674-0077
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-3065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive 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: DR. VICTOR L DELGADO
Title or Position: PRESIDENT
Credential: MD
Phone: 787-884-3065