Healthcare Provider Details

I. General information

NPI: 1730500711
Provider Name (Legal Business Name): WELLNESS SERVICES, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 10/05/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALLE RUIZ BELVIS
MOROVIS PR
00687-3090
US

IV. Provider business mailing address

PO BOX 2120
MOROVIS PR
00687-4120
US

V. Phone/Fax

Practice location:
  • Phone: 787-369-0788
  • Fax:
Mailing address:
  • Phone: 787-369-0788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIA E. MARTINEZ- RIVERA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-369-0788