Provider Demographics
NPI:1609507615
Name:RHEUMATOLOGY AND WELLNESSS CLINIC LLC
Entity Type:Organization
Organization Name:RHEUMATOLOGY AND WELLNESSS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANAIIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NADAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-462-4462
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-0228
Mailing Address - Country:US
Mailing Address - Phone:787-462-4462
Mailing Address - Fax:
Practice Address - Street 1:URB EXT VILLA RICA
Practice Address - Street 2:J16 CALLE 2 STE 202
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-998-1948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty