Healthcare Provider Details

I. General information

NPI: 1215648241
Provider Name (Legal Business Name): ALLERGIMMUNO RHZU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 AVE MANUEL DOMENECH
SAN JUAN PR
00918-3511
US

IV. Provider business mailing address

317 AVE MANUEL DOMENECH
SAN JUAN PR
00918-3511
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-5715
  • Fax: 787-764-3709
Mailing address:
  • Phone: 787-764-5715
  • Fax: 787-764-3709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAEL H. ZARAGOZA-URDAZ
Title or Position: OWNER
Credential: MD
Phone: 787-764-5715