Healthcare Provider Details

I. General information

NPI: 1073859971
Provider Name (Legal Business Name): THE MILLENNIUM INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2012
Last Update Date: 12/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CALLE COSME REPARTO SAN LUCAS
SAN JUAN PR
00926-5955
US

IV. Provider business mailing address

1 CALLE COSME REPARTO SAN LUCAS
SAN JUAN PR
00926-5955
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-0138
  • Fax: 787-720-6072
Mailing address:
  • Phone: 787-708-0138
  • Fax: 787-720-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License NumberLIC 44
License Number StatePR

VIII. Authorized Official

Name: DR. RAFAEL VILAR
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 787-708-0138