# MANATI HEALTH CLINIC PHG

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

## Provider details

- **NPI number:** 1336470590
- **Authorized official:** IDALIA SOTO RIVERA (MANAGER)
- **Authorized official phone:** (787) 368-9787

## Contact information

- **Practice address:** CARR. \#2 MARGINAL, URB. FELIX CORDOVA DAVILA, MANATI, PR 00674
- **Practice address phone:** (939) 358-1979
- **Practice address fax:** (939) 358-1880
- **Mailing address:** 400 CALLE CALAF STE 361, SAN JUAN, PR 00918-1314
- **Mailing address phone:** (787) 993-3535
- **Mailing address fax:** (787) 522-0649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/27/2010
- **Last updated:** 01/27/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 660638103 | OPTION HEALTH GROUP, INC. | PR |