Healthcare Provider Details

I. General information

NPI: 1174467237
Provider Name (Legal Business Name): UNA MANO AMIGA HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 464 KM 2.4 ACEITUNAS
MOCA PR
00676-9265
US

IV. Provider business mailing address

HC 3 BOX 9110
MOCA PR
00676-9265
US

V. Phone/Fax

Practice location:
  • Phone: 939-372-4040
  • Fax:
Mailing address:
  • Phone: 939-372-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BLADYS JOHANNA LOPEZ VILLANUEVA
Title or Position: PRESIDENT
Credential: MD
Phone: 939-372-4040