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General NPI Number Information
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NPI Number | 1427776186
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Entity Type | Organization
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Legal Business Name | TANAMA HEALTHCARE LLC
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/12/2023
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Provider Practice Location Address
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Address Line | 102 CALLE FRANCISCO JAURREGUI
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City | ARECIBO
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State | PR
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Zip | 00612-4572
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Country | US
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Telephone | 787-816-5041
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Fax | 787-881-5742
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Provider Business Mailing Address
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Address Line | 702 CALLE UN APT G1
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City | SAN JUAN
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State | PR
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Zip | 00907-4202
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Country | US
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Telephone | 787-506-0723
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Fax | 787-881-5742
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Authorized Official
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Title or Position | CEO & OWNER
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Name | DANTE ISAAC RODRIGUEZ GONZALEZ
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Credential | MD, MHSA
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Telephone | 787-816-5041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 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 #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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