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General NPI Number Information
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NPI Number | 1497217442
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Entity Type | Organization
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Legal Business Name | HEALTHSTAT CLINICS LLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | L5 CONDOMINIO CRYSTAL HOUSE
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City | SAN JUAN
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State | PR
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Zip | 00902
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Country | US
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Telephone | 787-597-4477
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 182
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City | VEGA BAJA
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State | PR
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Zip | 00694-0182
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Country | US
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Telephone | 787-597-4477
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MR. MARCELO QUILES
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Credential |
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Telephone | 787-597-4477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service 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 | 261QH0700X
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Taxonomy Name | Hearing and Speech 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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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