Healthcare Provider Details

I. General information

NPI: 1366053845
Provider Name (Legal Business Name): CLINICA LAS AMERICAS GUAYNABO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2020
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 AVE FRANKLIN D ROOSEVELT STE 103
SAN JUAN PR
00918-2129
US

IV. Provider business mailing address

PO BOX 7891
GUAYNABO PR
00970-7891
US

V. Phone/Fax

Practice location:
  • Phone: 787-789-1996
  • Fax:
Mailing address:
  • Phone: 787-789-1996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NURY TOLEDO NUNEZ
Title or Position: SVP & STRATEGY PHARMACY
Credential:
Phone: 787-789-1996