Provider Demographics
NPI:1780891853
Name:HOLISTIC HEALTH
Entity type:Organization
Organization Name:HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-783-3253
Mailing Address - Street 1:653 CALLE HIPODROMO
Mailing Address - Street 2:SUITE # 101
Mailing Address - City:SANTURCE
Mailing Address - State:PR
Mailing Address - Zip Code:00909
Mailing Address - Country:US
Mailing Address - Phone:787-783-3253
Mailing Address - Fax:787-783-3253
Practice Address - Street 1:653 CALLE HIPODROMO
Practice Address - Street 2:SUITE # 101
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909
Practice Address - Country:US
Practice Address - Phone:787-783-3253
Practice Address - Fax:787-783-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR242261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherPROVIDER CIGNA