Provider Demographics
NPI:1508613589
Name:METRO PAVIA AT HOME, LLC
Entity Type:Organization
Organization Name:METRO PAVIA AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-705-6982
Mailing Address - Street 1:PO BOX 11938
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1938
Mailing Address - Country:US
Mailing Address - Phone:787-235-6886
Mailing Address - Fax:787-705-6794
Practice Address - Street 1:CARR. 345 KM 2.1 INT. CARR PR 2 KM 2.0
Practice Address - Street 2:PLAZA MONSERRATE IV BO. LAVADEROS
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-833-1985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion