Healthcare Provider Details

I. General information

NPI: 1902588965
Provider Name (Legal Business Name): TUTUPR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PALACIOS DE MARBELLA 1020 CALLE DEL PALMAR
TOA ALTA PR
00953
US

IV. Provider business mailing address

PALACIOS DE MARBELLA 1020 CALLE DEL PALMAR
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 939-642-6901
  • Fax:
Mailing address:
  • Phone: 939-642-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RENIER J BONILLA
Title or Position: PRESIDENT
Credential:
Phone: 939-642-6901