# ARARAT LIPODYSTROPHY CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245309665
- **Authorized official:** MR. JUAN BAUTISTA RIVERA III (EXCECUTIVE DIRECTOS)
- **Authorized official phone:** (787) 284-5884

## Contact information

- **Practice address:** 8169 CALLE CONCORDIA STE 411, COND. SAN VICENTE, PONCE, PR 00717-1567
- **Practice address phone:** (787) 284-5884
- **Practice address fax:** (787) 284-5874
- **Mailing address:** 8169 CALLE CONCORDIA STE 411, COND. SAN VICENTE, PONCE, PR 00717-1567
- **Mailing address phone:** (787) 284-5884
- **Mailing address fax:** (787) 284-5874

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12061 | PR | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 09/11/2025