Healthcare Provider Details

I. General information

NPI: 1538690904
Provider Name (Legal Business Name): DRX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 AVE FERNANDEZ JUNCOS STE 101 EDIFICIO BETANCOURT
SAN JUAN PR
00909-2761
US

IV. Provider business mailing address

PO BOX 8419
SAN JUAN PR
00910-0419
US

V. Phone/Fax

Practice location:
  • Phone: 787-296-8880
  • Fax:
Mailing address:
  • Phone: 787-296-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: ASDRIEL MENDEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-296-8880