# VILLA LOS SANTOS CLINIC, LLC

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

## Provider details

- **NPI number:** 1992415343
- **Authorized official:** MARIA J GONZALEZ AGRASO (ADMINISTRADORA)
- **Authorized official phone:** (787) 879-1585

## Contact information

- **Practice address:** VILLA LOS SANTOS, CALLE 16 V 1, ARECIBO, PR 00612
- **Practice address phone:** (787) 879-1585
- **Practice address fax:** (787) 879-4315
- **Mailing address:** PO BOX 9091, ARECIBO, PR 00613-9091
- **Mailing address phone:** (787) 879-1585
- **Mailing address fax:** (787) 879-4315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/28/2022
- **Last updated:** 07/30/2024