# ANGELORUM, INC.

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

## Provider details

- **NPI number:** 1285009613
- **Authorized official:** DR. LUIS M GONZALEZ SR. M.D (CEO /DIRECTOR MEDIC)
- **Authorized official phone:** (787) 316-1212

## Contact information

- **Practice address:** CARR 693 KM 13.8, SUITE 171 BO BRENAS, VEGA ALTA, PR 00692
- **Practice address phone:** (787) 270-3330
- **Practice address fax:** (787) 915-7594
- **Mailing address:** PO BOX 419, VEGA ALTA, PR 00692-0419
- **Mailing address phone:** (787) 270-3330
- **Mailing address fax:** (787) 915-7594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 9663 | PR | Yes |

## Other

- **Enumeration date:** 12/10/2015
- **Last updated:** 12/10/2015