Provider Demographics
NPI:1649421165
Name:IV HOME INFUSION
Entity Type:Organization
Organization Name:IV HOME INFUSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GONZALEZ COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-349-7631
Mailing Address - Street 1:COND PRIMAVERA 2340
Mailing Address - Street 2:APT 25 CARR NO. 2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-0000
Mailing Address - Country:US
Mailing Address - Phone:787-349-7631
Mailing Address - Fax:
Practice Address - Street 1:COND PRIMAVERA 2340
Practice Address - Street 2:APT 25 CARR NO. 2
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-0000
Practice Address - Country:US
Practice Address - Phone:787-349-7631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion