Healthcare Provider Details

I. General information

NPI: 1750254306
Provider Name (Legal Business Name): PRIVATEMED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 ASHFORD AVE SUITE 113A
SAN JUAN PR
00907-1511
US

IV. Provider business mailing address

1451 AVE ASHFORD
SAN JUAN PR
00907-1511
US

V. Phone/Fax

Practice location:
  • Phone: 939-382-1111
  • Fax: 939-382-1111
Mailing address:
  • Phone: 939-382-1111
  • Fax: 939-382-1111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOYCE C ORTIZ
Title or Position: VICE PRESIDENT
Credential: MS, CAP
Phone: 939-382-1111