Healthcare Provider Details

I. General information

NPI: 1780891853
Provider Name (Legal Business Name): HOLISTIC HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

653 CALLE HIPODROMO SUITE # 101
SANTURCE PR
00909
US

IV. Provider business mailing address

653 CALLE HIPODROMO SUITE # 101
SANTURCE PR
00909
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-3253
  • Fax: 787-783-3253
Mailing address:
  • Phone: 787-783-3253
  • Fax: 787-783-3253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number242
License Number StatePR

VIII. Authorized Official

Name: DR. GILBERT SETH WEINER
Title or Position: DOCTOR
Credential: D.C.
Phone: 787-783-3253