Healthcare Provider Details

I. General information

NPI: 1952087876
Provider Name (Legal Business Name): ENDO AFC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 PONCE BYPASS
PONCE PR
00717
US

IV. Provider business mailing address

PO BOX 477
COAMO PR
00769
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-8686
  • Fax: 787-259-7364
Mailing address:
  • Phone: 787-922-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEGYARI FIGUEROA CRUZ
Title or Position: MEDICAL DOCTOR
Credential: MD, DABOM
Phone: 787-922-0431