Healthcare Provider Details

I. General information

NPI: 1578152294
Provider Name (Legal Business Name): MEDPLUS HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2021
Last Update Date: 01/17/2021
Certification Date: 01/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 AVE JESUS T PINERO STE 100
SAN JUAN PR
00927-3921
US

IV. Provider business mailing address

PO BOX 364109
SAN JUAN PR
00936-4109
US

V. Phone/Fax

Practice location:
  • Phone: 787-333-6998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SULTAN S YASSIN
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 787-598-9459