Provider Demographics
NPI:1235895962
Name:BIENESTAR HEALTH GROUP
Entity Type:Organization
Organization Name:BIENESTAR HEALTH GROUP
Other - Org Name:BIENESTAR MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DR. JOSE
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:RODRIGUEZ-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-545-0522
Mailing Address - Street 1:CALLE BALDORIOTY DE CASTRO 165 NORTE
Mailing Address - Street 2:BUZON 2 BO LLANOS
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:939-545-0700
Mailing Address - Fax:
Practice Address - Street 1:CALLE BALDORIOTY DE CASTRO 165 NORTE
Practice Address - Street 2:BUZON 2 BO LLANOS
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:939-545-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health