Provider Demographics
NPI:1003033747
Name:CLINICA LAS AMERICAS GUAYNABO, INC
Entity type:Organization
Organization Name:CLINICA LAS AMERICAS GUAYNABO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP & PHARMACY STRATEGY
Authorized Official - Prefix:
Authorized Official - First Name:NURY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDO NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-789-1996
Mailing Address - Street 1:PMB 509
Mailing Address - Street 2:P.O.BOX 7891
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-7891
Mailing Address - Country:US
Mailing Address - Phone:787-789-1919
Mailing Address - Fax:787-789-1921
Practice Address - Street 1:CASA LINA AVE. #1 SUITE 101
Practice Address - Street 2:1 AVE CASA LINDA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00969-9000
Practice Address - Country:US
Practice Address - Phone:787-789-1996
Practice Address - Fax:787-789-2180
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICA LAS AMERICAS GUAYNABO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-20
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40035OtherODONTOLOGIA GENERAL