Healthcare Provider Details

I. General information

NPI: 1609771716
Provider Name (Legal Business Name): QUALITY IMPACT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB LEVITTOWN AVENIDA DEL VALLE #3370
TOA BAJA PR
00949-9998
US

IV. Provider business mailing address

COND LAGO PLAYA CORAL 3000 APT 2231
TOA BAJA PR
00949-9998
US

V. Phone/Fax

Practice location:
  • Phone: 787-667-8653
  • Fax:
Mailing address:
  • Phone: 787-667-8653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: BLANCA RODRIGUEZ VELEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-667-8653