Healthcare Provider Details

I. General information

NPI: 1427710177
Provider Name (Legal Business Name): HOY DOC PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 07/13/2022
Certification Date: 07/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CALLE ELEONOR ROOSEVELT
SAN JUAN PR
00918-3106
US

IV. Provider business mailing address

117 CALLE ELEONOR ROOSEVELT
SAN JUAN PR
00918-3130
US

V. Phone/Fax

Practice location:
  • Phone: 732-627-1071
  • Fax:
Mailing address:
  • Phone: 732-627-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EUGENE SAMUELS
Title or Position: LEGAL COUNSEL
Credential:
Phone: 480-393-0684