Provider Demographics
NPI:1578279485
Name:CLINICA TODO SALUD - AIBONITO, LLC
Entity Type:Organization
Organization Name:CLINICA TODO SALUD - AIBONITO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEREZ FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-545-7073
Mailing Address - Street 1:PO BOX 71114
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-8014
Mailing Address - Country:US
Mailing Address - Phone:787-622-3000
Mailing Address - Fax:
Practice Address - Street 1:PARQUE INDUSTRIAL BO LLANOS L-238-0-61
Practice Address - Street 2:CARR 725 KM 0.5
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-545-7073
Practice Address - Fax:787-620-5379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
No2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone DensitometryGroup - Multi-Specialty
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Multi-Specialty
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21-056OtherDEPARTMENT OF HEALTH