Organization
NUGEN LABS, LLC
Active
Organization
NUGEN LABS, LLC
Active
Parent organization
BIENESTAR HEALTH GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
BIENESTAR HEALTH GROUP
Authorized official
DR. JOSE DE TERREFORTE-DIAZ MD, MPH (CEO)
(939) 545-0522
Entity
Organization
Contact information
Practice address
EDIFICIO CENTRAL, CALLE BALDORIOTY 165 NORTE, BUZON #2, AIBONITO, PR 00705
(939) 545-0522
(939) 545-0700
Mailing address
EDIFICIO CENTRAL, CALLE BALDORIOTY 165 NORTE, BUZON #2, AIBONITO, PR 00705
(939) 545-0522
(939) 545-0700
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/05/2020
Last updated
05/14/2020
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