Healthcare Provider Details

I. General information

NPI: 1083335442
Provider Name (Legal Business Name): CONTUSALUD TE LLEVA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 AVE TITO CASTRO LA RAMBLA PLAZA SUITE 135
PONCE PR
00716
US

IV. Provider business mailing address

606 AVE TITO CASTRO LA RAMBLA PLAZA SUITE 135
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-613-7845
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name: EDGARDO FIGUEROA MUNIZ
Title or Position: PRIMARY OFFICIAL
Credential:
Phone: 787-613-7845