Provider Demographics
NPI:1497217442
Name:HEALTHSTAT CLINICS LLC
Entity Type:Organization
Organization Name:HEALTHSTAT CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-597-4477
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-0182
Mailing Address - Country:US
Mailing Address - Phone:787-597-4477
Mailing Address - Fax:
Practice Address - Street 1:L5 CONDOMINIO CRYSTAL HOUSE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00902
Practice Address - Country:US
Practice Address - Phone:787-597-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Single Specialty