Provider Demographics
NPI:1134821630
Name:CLINICA TODO SALUD - AIBONITO, LLC
Entity type:Organization
Organization Name:CLINICA TODO SALUD - AIBONITO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER RELATIONSHIP ACCT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:787-622-3000
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:787-545-7073
Mailing Address - Fax:
Practice Address - Street 1:CARR #2 KM 129.5
Practice Address - Street 2:BO VICTORIA
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-545-7073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICA TODO SALUD - AIBONITO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-20
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty