Healthcare Provider Details

I. General information

NPI: 1245146166
Provider Name (Legal Business Name): CLINICA YAGUEZ, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA YAGUEZ SUITE 104-106, 204 STREET MCKINLEY #114
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 698
MAYAGUEZ PR
00681-0698
US

V. Phone/Fax

Practice location:
  • Phone: 787-832-8444
  • Fax: 787-805-7440
Mailing address:
  • Phone: 787-832-8444
  • Fax: 787-805-7440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS I HUERTAS
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 787-832-8444