Provider Demographics
NPI:1740082213
Name:NOZOMI INCORPORADO
Entity type:Organization
Organization Name:NOZOMI INCORPORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERNANDEZ BEAUCHAMP
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:787-322-7994
Mailing Address - Street 1:PO BOX 6451
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6451
Mailing Address - Country:US
Mailing Address - Phone:787-322-7994
Mailing Address - Fax:
Practice Address - Street 1:I12 CALLE WILSON
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1357
Practice Address - Country:US
Practice Address - Phone:787-322-7994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service