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General NPI Number Information
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NPI Number | 1730009028
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Entity Type | Organization
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Legal Business Name | AZZUR ADVANCED THERAPEUTICS LLC
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 1127 AVE MUNOZ RIVERA LOCAL 4 VILLA GRILLASCA
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 939-384-4378
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Fax |
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Provider Business Mailing Address
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Address Line | 917 DOLORES P MACHADO URB VILLAS DE RIO CANAS
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City | PONCE
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State | PR
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Zip | 00728-1933
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Country | US
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Telephone | 939-384-4378
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OMAR JAVIER RODRIGUEZ
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Credential |
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Telephone | 787-667-7674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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