MEDICARE: WELLNESS & HOPE MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1366573834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS & HOPE MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	623 AVE PONCE DE LEON
Second Line	:	SUITE 306
City	:	SAN JUAN
State	:	PR
Zip	:	00918
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1753 AVE PAZ GRANELA
Second Line	:	SANTIAGO IGLESIAS PANTIN
City	:	SAN JUAN
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-596-8201
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ALLAN PENA
Credential	:
Telephone Number	:	787-596-8201

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	08/22/2020

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