# SPECIALTY HEALTHCARE CLINIC AT PEPINO LLC

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

## Provider details

- **NPI number:** 1477201036
- **Authorized official:** JOSE M OLAVARRIA INFANTE (PRINCIPAL OFFICER)
- **Authorized official phone:** (939) 630-7100

## Contact information

- **Practice address:** AVE. EMERITO ESTRADA RIVERA, CARR. 125 \# 546, SAN SEBASTIAN, PR 00685
- **Practice address phone:** (939) 630-7100
- **Mailing address:** PO BOX 1045, DORADO, PR 00646-1045
- **Mailing address phone:** (787) 989-0414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 08/21/2023