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General NPI Number Information
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NPI Number | 1134821630
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Entity Type | Organization
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Legal Business Name | CLINICA TODO SALUD - AIBONITO, LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | CARR #2 KM 129.5 BO VICTORIA
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City | AGUADILLA
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State | PR
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Zip | 00603
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Country | US
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Telephone | 787-545-7073
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 71114
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City | SAN JUAN
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State | PR
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Zip | 00936-8014
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Country | US
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Telephone | 787-545-7073
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Fax |
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Authorized Official
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Title or Position | PROVIDER RELATIONSHIP ACCT MANAGER
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Name | GLORIA HERNANDEZ
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Credential | MHSA
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Telephone | 787-622-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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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 | 207N00000X
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Taxonomy Name | Dermatology 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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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