# PRAVAN WELLNESS, LLC

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

## Provider details

- **NPI number:** 1780227504
- **Authorized official:** DR. RUTH L GONZALEZ PSYD (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (787) 310-7900

## Contact information

- **Practice address:** 1511 AVE PONCE DE LEON STE 3, SAN JUAN, PR 00909-5001
- **Practice address phone:** (787) 310-7900
- **Mailing address:** 1511 AVE PONCE DE LEON STE 3, SAN JUAN, PR 00909-5001
- **Mailing address phone:** (787) 339-2639

## Taxonomy

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

## Other

- **Enumeration date:** 10/24/2019
- **Last updated:** 10/24/2019