# PREPVEN CORP

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

## Provider details

- **NPI number:** 1366060766
- **Authorized official:** RONALD COLLAZO PAGAN MD (DIRECTOR)
- **Authorized official phone:** (787) 918-8618

## Contact information

- **Practice address:** 315 CALLE MANUEL DOMENECH STE 1, SAN JUAN, PR 00918-3513
- **Practice address phone:** (787) 918-8618
- **Mailing address:** 315 AVE MANUEL DOMENECH STE 1, SAN JUAN, PR 00918-3513
- **Mailing address phone:** (787) 918-8618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/12/2020
- **Last updated:** 01/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 039197200 | — | PR |