NPI Code Details Logo

NPI 1578279485

NPI 1578279485 : CLINICA TODO SALUD - AIBONITO, LLC : AIBONITO, PR

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1578279485
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CLINICA TODO SALUD - AIBONITO, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    01/24/2023
-----------------------------------------------------
    Last Update Date     |    05/14/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    PARQUE INDUSTRIAL BO LLANOS L-238-0-61 CARR 725 KM 0.5
-----------------------------------------------------
    City                 |    AIBONITO
-----------------------------------------------------
    State                |    PR
-----------------------------------------------------
    Zip                  |    00705
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    787-545-7073
-----------------------------------------------------
    Fax                  |    787-620-5379
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 70105 
-----------------------------------------------------
    City                 |    SAN JUAN
-----------------------------------------------------
    State                |    PR
-----------------------------------------------------
    Zip                  |    00936-8014
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    787-545-7073
-----------------------------------------------------
    Fax                  |    787-620-5379
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    VP OF CLINICS
-----------------------------------------------------
    Name                 |     MARCOS  AGUILA SASTRE 
-----------------------------------------------------
    Credential           |    MHSA
-----------------------------------------------------
    Telephone            |    787-622-3000
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QR0206X
-----------------------------------------------------
    Taxonomy Name        |    Mammography Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    2085B0100X
-----------------------------------------------------
    Taxonomy Name        |    Body Imaging Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    2085U0001X
-----------------------------------------------------
    Taxonomy Name        |    Diagnostic Ultrasound Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    2471B0102X
-----------------------------------------------------
    Taxonomy Name        |    Bone Densitometry Radiologic Technologist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
    Taxonomy Code        |    2471C3401X
-----------------------------------------------------
    Taxonomy Name        |    Computed Tomography Radiologic Technologist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
    Taxonomy Code        |    261QR0200X
-----------------------------------------------------
    Taxonomy Name        |    Radiology Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
    Taxonomy Code        |    2085R0202X
-----------------------------------------------------
    Taxonomy Name        |    Diagnostic Radiology Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.