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General NPI Number Information
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NPI Number | 1558205716
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Entity Type | Organization
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Legal Business Name | EDEN HEALTH CLINICS LLC
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | CALLE VICENTITA DELIZ #1,
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0000
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Country | US
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Telephone | 704-534-7997
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE VICENTITA DELIZ #1
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City | QEUBRADILLAS
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State | PR
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Zip | 00678-0000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADOR
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Name | MRS. MARIANNIE SEGARRA RAMOS
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Credential |
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Telephone | 704-534-7997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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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 | 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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