Healthcare Provider Details

I. General information

NPI: 1215719711
Provider Name (Legal Business Name): EVERNEW MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 CALLE 49 SE
SAN JUAN PR
00921-2319
US

IV. Provider business mailing address

2-2 PARKVILLE CT
GUAYNABO PR
00969-4751
US

V. Phone/Fax

Practice location:
  • Phone: 787-232-0007
  • Fax: 850-353-7180
Mailing address:
  • Phone: 787-342-7504
  • Fax: 850-353-7180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DARLIN CELESTE DIAZ-GOMEZ
Title or Position: OWNER
Credential: MD
Phone: 787-342-7504