Healthcare Provider Details

I. General information

NPI: 1346611936
Provider Name (Legal Business Name): METRO PAVIA HEALTHCARE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3198 CALLE MARINA
PONCE PR
00717
US

IV. Provider business mailing address

PO BOX 9976 COTTO STATION
ARECIBO PR
00613
US

V. Phone/Fax

Practice location:
  • Phone: 787-772-9850
  • Fax: 787-274-8895
Mailing address:
  • Phone: 787-772-9850
  • Fax: 787-274-8895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. VIVIAN SOLIVAN
Title or Position: PRESIDENT
Credential:
Phone: 787-234-8865