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General NPI Number Information
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NPI Number | 1700661782
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Entity Type | Organization
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Legal Business Name | SALUD 360 LLC
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Dates
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Enumeration Date | 08/29/2023
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | BALDORIOTY NORTE 165
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City | AIBONITO
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State | PR
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Zip | 00705
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Country | US
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Telephone | 787-694-3202
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 521
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City | PATILLAS
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State | PR
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Zip | 00723-0521
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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 | OWNER
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Name | KARLA MARIE RODRIGUEZ TIRADO
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Credential | MD
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Telephone | 787-929-1505
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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 |
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License Number State |
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