Healthcare Provider Details

I. General information

NPI: 1083952014
Provider Name (Legal Business Name): MILLENNIUM INSTITUTE FOR ADVANCE NURSING CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2013
Last Update Date: 01/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUITE 112, MSC 404 100 GRAND BOULEVARD PASEOS
SAN JUAN PR
00926-5955
US

IV. Provider business mailing address

CALLE COSME, REPARTO SAN LUCAS ENTRADA SECTOR CANEJAS
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-708-0325
  • Fax: 787-720-6072
Mailing address:
  • Phone: 787-708-0325
  • Fax: 787-720-6072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberLIC44 CNC NUM 12-101
License Number StatePR

VIII. Authorized Official

Name: DR. JUAN J RODRIGUEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-708-0138