Healthcare Provider Details

I. General information

NPI: 1558038471
Provider Name (Legal Business Name): IPAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2021
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ANEXO HOSPITAL METROPOLITANO DE LA MONTANA CALLE DR. ISAAC GONZALEZ
UTUADO PR
00641
US

IV. Provider business mailing address

PO BOX 1441
UTUADO PR
00641-1441
US

V. Phone/Fax

Practice location:
  • Phone: 787-248-1534
  • Fax:
Mailing address:
  • Phone: 787-248-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELICA MAGLEN RIVERA
Title or Position: ADMINISTRADORA
Credential:
Phone: 787-248-1534