# ECOHEALTH MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ECOHEALTH MEDICAL GROUP LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386429488
- **Authorized official:** DAIARALIZ LOPEZ (PRESIDENT)
- **Authorized official phone:** (787) 210-9816

## Contact information

- **Practice address:** 117 ELEANOR ROOSEVELT AVENUE, TRES RIOS OFFICE BUILDING SUITE 500, SAN JUAN, PR 00918
- **Practice address phone:** (787) 705-7979
- **Practice address fax:** (787) 705-7970
- **Mailing address:** URB LOS MONTES, CALLE FLAMENCO \#592, DORADO, PR 00646
- **Mailing address phone:** (787) 210-9816

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2023
- **Last updated:** 02/22/2024