Healthcare Provider Details

I. General information

NPI: 1386125359
Provider Name (Legal Business Name): UDAI HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARR. # 2-51, TORRE MEDICA 2 TORRE MEDICA 2 DR PEDRO BLANCO LUGO
MANATI PR
00674
US

IV. Provider business mailing address

200 CARR. # 2-51, TORRE MEDICA 2 TORRE MEDICA 2 DR PEDRO BLANCO LUGO
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-507-3644
  • Fax: 787-860-0844
Mailing address:
  • Phone: 787-507-3644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
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: MONICA LIZ RODRIGUEZ
Title or Position: MANAGER
Credential:
Phone: 787-507-3644