Healthcare Provider Details

I. General information

NPI: 1376556571
Provider Name (Legal Business Name): MILLENNIUM INSTITUTE FOR ADVANCE NURSING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE COSME REPARTO SAN LIUCAS
RIO PIEDRAS PR
00926-5955
US

IV. Provider business mailing address

100 GRAND PASEO BLVD STE 112 MSC 404
SAN JUAN PR
00926-5905
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-0138
  • Fax: 787-720-6072
Mailing address:
  • Phone: 787-708-0138
  • Fax: 787-720-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberLIC 5 CNC -01-044
License Number StatePR

VIII. Authorized Official

Name: ANA PILAR RODRIGUEZ
Title or Position: EXECUTIVE DIRECTOR
Credential: MHSA
Phone: 787-708-0138