Healthcare Provider Details

I. General information

NPI: 1891628657
Provider Name (Legal Business Name): ELEVA HEARING & BALANCE INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO TORRE DEL METROPOLITANO SUITE 202 CARRETERA 21
SAN JUAN PR
00921
US

IV. Provider business mailing address

CONDOMINIO TORRE DEL METROPOLITANO1789 CARR 21 STE 202
SAN JUAN PR
00921-3335
US

V. Phone/Fax

Practice location:
  • Phone: 787-293-7485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: EDIBERTO RODRIGUEZ DE JESUS III
Title or Position: PRESIDENT
Credential: AUD
Phone: 787-293-7485