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General NPI Number Information
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NPI Number | 1538301932
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Entity Type | Organization
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Legal Business Name | BEYOND WELLNESS INC.
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | X1154 AVE PONTEZUELA VISTAMAR
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City | CAROLINA
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State | PR
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Zip | 00983-2060
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Country | US
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Telephone | 787-607-6007
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Fax |
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Provider Business Mailing Address
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Address Line | 5016 PASEO LA CONSTANCIA HACIENDAS DEL MONTE
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City | COTO LAUREL
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State | PR
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Zip | 00780-2311
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Country | US
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Telephone | 787-690-9580
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AXEL ENRI MARTINEZ
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Credential | M.D.
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Telephone | 787-607-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17055
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16987
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License Number State | PR
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