Healthcare Provider Details

I. General information

NPI: 1912811746
Provider Name (Legal Business Name): ALTIX MEDICAL PR PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 AVENIDA CONDADO STE 3
SAN JUAN PR
00907-1894
US

IV. Provider business mailing address

301 ALMERIA AVE STE 240
CORAL GABLES FL
33134-5822
US

V. Phone/Fax

Practice location:
  • Phone: 239-842-6320
  • Fax: 645-239-2089
Mailing address:
  • Phone: 239-842-6320
  • Fax: 645-239-2089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. LEO DAMASCO
Title or Position: OWNER
Credential: MD
Phone: 239-842-6320