Healthcare Provider Details

I. General information

NPI: 1205743192
Provider Name (Legal Business Name): ABC CENTRO INTEGRAL FAMILIAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 AVE JESUS T PINERO STE 102-2021
SAN JUAN PR
00918-4374
US

IV. Provider business mailing address

290 AVE JESUS T PINERO STE 102-2021
SAN JUAN PR
00918-4374
US

V. Phone/Fax

Practice location:
  • Phone: 939-493-3430
  • Fax:
Mailing address:
  • Phone: 939-493-3430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: INARAH AGUEDA FELIX
Title or Position: OWNER
Credential:
Phone: 939-203-4420