=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104757319
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DELERMED HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2026
-----------------------------------------------------
Last Update Date | 05/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 463 AVE PONCE DE LEON FLOOR B
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00917-3710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-717-1895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 14441
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00916-4441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-717-1895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARIA DEL CARMEN MONTANEZ CONCEPCION
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-717-1895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------