Provider Demographics
NPI:1497481469
Name:WOMEN'S HEALTH AND AESTHETIC CLINIC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH AND AESTHETIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:PENA VALDIVIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-236-9496
Mailing Address - Street 1:PO BOX 2012
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2012
Mailing Address - Country:US
Mailing Address - Phone:787-236-9496
Mailing Address - Fax:
Practice Address - Street 1:CARR. #2 BARRIO COTTO NORTE KM 47.4
Practice Address - Street 2:OFICINA #2-07 EDIFICIO MEDICO PEDRO BLANCO LUGO
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-236-9496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty