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General NPI Number Information
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NPI Number | 1962217919
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HEALTH GROUP LLC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | CALLE A 44 URB EL RECREO
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City | HUMACAO
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State | PR
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Zip | 00791-3345
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Country | US
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Telephone | 939-585-5122
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Fax |
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Provider Business Mailing Address
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Address Line | HC 2 BOX 4688
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City | SABANA HOYOS
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State | PR
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Zip | 00688-9553
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Country | US
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Telephone | 939-585-5122
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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 A CONCEPCION
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Credential | MD
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Telephone | 939-585-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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