Provider Demographics
NPI:1659796357
Name:HEALTH PREVENTION GROUP
Entity Type:Organization
Organization Name:HEALTH PREVENTION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALVADOR
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-310-3105
Mailing Address - Street 1:PO BOX 6881
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00914-6881
Mailing Address - Country:US
Mailing Address - Phone:787-310-3105
Mailing Address - Fax:787-783-5100
Practice Address - Street 1:CARR 638 KM 6.0
Practice Address - Street 2:BO MIRAFLORES
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-310-3105
Practice Address - Fax:787-783-5100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1427091040Medicare UPIN