Organization
IDENTITY HEALTH GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS E PRATS MD (PRESIDENT)
(939) 699-6013
Entity
Organization
Contact information
Practice address
47 CALLE MUNOZ RIVERA W, RINCON, PR 00677-2125
(939) 699-6013
Mailing address
PO BOX 1092, RINCON, PR 00677-1092
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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