Healthcare Provider Details

I. General information

NPI: 1164353959
Provider Name (Legal Business Name): PPRHI LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 AVE. ARTERIAL HOSTOS, 332, EDI T, APT 402
SAN JUAN PR
00918-2987
US

IV. Provider business mailing address

155 AVE. ARTERIAL HOSTOS, APT. 402, BOX 332
SAN JUAN PR
00918-2987
US

V. Phone/Fax

Practice location:
  • Phone: 939-254-0424
  • Fax:
Mailing address:
  • Phone: 939-254-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: JEANDELIZE SOTO ROSA
Title or Position: OWNER
Credential: MD
Phone: 939-254-0424