Healthcare Provider Details

I. General information

NPI: 1639684905
Provider Name (Legal Business Name): PRECISION HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2017
Last Update Date: 12/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HERNANDEZ CARRION STREET SUITE 210 MMC PROFESSIONAL PLAZA
MANATI PR
00674
US

IV. Provider business mailing address

200 HERNANDEZ CARRION STREET SUITE 4210 MMC PROFESSIONAL PLAZA
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-621-4747
  • Fax: 787-621-3263
Mailing address:
  • Phone: 787-621-4747
  • Fax: 787-621-3263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StatePR

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. CARMEN M ROSADO
Title or Position: OFFICE MANAGER
Credential:
Phone: 787-621-4747