Healthcare Provider Details

I. General information

NPI: 1376184184
Provider Name (Legal Business Name): CONSEJERIA DE SALUD INTEGRAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB MONTE VERDE G33 CALLE 4
TOA ALTA PR
00953
US

IV. Provider business mailing address

URB MONTE VERDE G33 CALLE 4
TOA ALTA PR
00953
US

V. Phone/Fax

Practice location:
  • Phone: 787-215-6703
  • Fax:
Mailing address:
  • Phone: 787-215-6703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY DIAZ
Title or Position: PRESITDENTE
Credential: PRESIDENTE
Phone: 787-215-6703