Healthcare Provider Details

I. General information

NPI: 1881548204
Provider Name (Legal Business Name): ELITE MEDICAL ALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE LUIS MUNOZ RIVERA #3
VEGA ALTA PR
00692-6417
US

IV. Provider business mailing address

PO BOX 4317
VEGA BAJA PR
00694-4317
US

V. Phone/Fax

Practice location:
  • Phone: 787-883-0124
  • Fax: 787-883-0222
Mailing address:
  • Phone: 787-883-0124
  • Fax: 787-883-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO A GARCIA
Title or Position: VICEPRESIDENT
Credential: MD
Phone: 787-883-0124