Healthcare Provider Details

I. General information

NPI: 1780198135
Provider Name (Legal Business Name): COMUNIDAD SALUDABLE DE LA MONTANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 AVE ROLANDO CABANAS
UTUADO PR
00641-2494
US

IV. Provider business mailing address

PO BOX 1151
UTUADO PR
00641-1151
US

V. Phone/Fax

Practice location:
  • Phone: 787-698-0073
  • Fax: 636-303-1822
Mailing address:
  • Phone: 787-698-0073
  • Fax: 636-303-1822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StatePR

VIII. Authorized Official

Name: MR. EMID NUNEZ
Title or Position: PRESIDENT & CEO
Credential:
Phone: 787-698-0073