=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497542385
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PROSABI LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2025
-----------------------------------------------------
Last Update Date | 08/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 CALLE GANDARA # 32
-----------------------------------------------------
City | COROZAL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00783-2055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-466-2620
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | H6 BOX 14875
-----------------------------------------------------
City | COROZAL
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-466-2620
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENTA
-----------------------------------------------------
Name | ARLYN RIVERA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 787-466-2620
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------