Provider Demographics
NPI:1215719711
Name:EVERNEW MEDICAL LLC
Entity type:Organization
Organization Name:EVERNEW MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLIN
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:DIAZ-GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-342-7504
Mailing Address - Street 1:2-2 PARKVILLE CT
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4751
Mailing Address - Country:US
Mailing Address - Phone:787-342-7504
Mailing Address - Fax:850-353-7180
Practice Address - Street 1:891 CALLE 49 SE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2319
Practice Address - Country:US
Practice Address - Phone:787-232-0007
Practice Address - Fax:850-353-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy