Healthcare Provider Details

I. General information

NPI: 1154236032
Provider Name (Legal Business Name): NANUWERKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL EMPORIUM 2 349 AVE HOSTOS SUITE A-29
MAYAGUEZ PR
00680-1509
US

IV. Provider business mailing address

URB EL PEDREGAL 87 CALLE MARMOL
SAN GERMAN PR
00683-8517
US

V. Phone/Fax

Practice location:
  • Phone: 939-202-3096
  • Fax:
Mailing address:
  • Phone: 939-202-3096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILMER OMAR TACORONTE
Title or Position: OWNER
Credential: MD
Phone: 939-202-3096