Provider Demographics
NPI:1245653682
Name:HEALTH UTILITY MANAGED CARE LLC
Entity type:Organization
Organization Name:HEALTH UTILITY MANAGED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIPOLITO
Authorized Official - Middle Name:BLADIMIR
Authorized Official - Last Name:COSTA PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-467-1007
Mailing Address - Street 1:PO BOX 367631
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7631
Mailing Address - Country:US
Mailing Address - Phone:787-467-1007
Mailing Address - Fax:787-740-6763
Practice Address - Street 1:STREET AGUAS BUENAS AB 9
Practice Address - Street 2:URB LAS CASCADAS
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3218
Practice Address - Country:US
Practice Address - Phone:787-467-1007
Practice Address - Fax:787-740-6763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization