Healthcare Provider Details

I. General information

NPI: 1407769383
Provider Name (Legal Business Name): RAIMUNDI MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AA9 CARR 678
VEGA ALTA PR
00692-6724
US

IV. Provider business mailing address

1 CALLE ESTACION STE 1
VEGA ALTA PR
00692-6541
US

V. Phone/Fax

Practice location:
  • Phone: 787-800-1800
  • Fax:
Mailing address:
  • Phone: 787-800-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTONIO T RAIMUNDI RAIMUNDI
Title or Position: PRESIDENT
Credential: MD
Phone: 787-800-1800