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General NPI Number Information
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NPI Number | 1073301404
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Entity Type | Organization
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Legal Business Name | OPEN CARE WELLNESS CENTER MOBILE
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 5031 CALLE TINTILLO
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City | GUAYNABO
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State | PR
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Zip | 00966-1647
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Country | US
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Telephone | 787-941-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 5031 CALLE TINTILLO
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City | GUAYNABO
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State | PR
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Zip | 00966-1647
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Country | US
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Telephone | 787-941-7272
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS M MARTINEZ
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Credential |
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Telephone | 787-237-1412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number |
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License Number State |
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