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General NPI Number Information
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NPI Number | 1063336972
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Entity Type | Organization
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Legal Business Name | NOVAVIDA HEALTH CLINIC LLC
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 36 CALLE BARBOSA ESQ MANUEL F. ROSSY
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 787-995-1900
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Fax |
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Provider Business Mailing Address
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Address Line | HC 11 BOX 48140
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City | CAGUAS
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State | PR
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Zip | 00725-9071
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LOURMARTIGH ORTIZ
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Credential | MD
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Telephone | 787-373-1947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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