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General NPI Number Information
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NPI Number | 1386405512
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Entity Type | Organization
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Legal Business Name | OCEANIC WELLNESS CENTER LLC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 416 AVE PONCE DE LEON STE 1500
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City | SAN JUAN
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State | PR
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Zip | 00918-3420
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Country | US
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Telephone | 787-402-8285
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Fax |
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Provider Business Mailing Address
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Address Line | 538 CALLE MARINA
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City | RIO GRANDE
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State | PR
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Zip | 00745-4639
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Country | US
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Telephone | 787-222-0455
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. PAMELA MICHELLE FIGUEROA
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Credential | MS, LMT
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Telephone | 787-402-8285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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