MEDICARE: PLAZA HEALTH LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1467508200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAZA HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 8949
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00988-8949
Country	:	US
Telephone Number	:	787-620-9600
Fax Number	:	787-797-8334

Provider Business Practice Location Address
First Line	:	CARR. 167 KM15.4 BO BUENA VISTA
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961-6385
Country	:	US
Telephone Number	:	787-620-9613
Fax Number	:	787-797-8334

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AWAD YASSIN
Credential	:
Telephone Number	:	939-988-0880

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	02/27/2026

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