Organization
PREMIUM HEALTH GROUP CLINIC
Active
Organization
PREMIUM HEALTH GROUP CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX CARRASQUILLO DMD (ADMINISTRATOR)
(787) 253-1101
Entity
Organization
Contact information
Practice address
LAGUNA GARDENS SHOPPING CENTER, SUITE 101A, CAROLINA, PR 00979
(787) 253-1101
(787) 791-6273
Mailing address
LAGUNA GARDENS SHOPPING CENTER, SUITE 101-A, CAROLINA, PR 00979
(787) 253-1101
(787) 791-6273
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Enumeration date
05/19/2009
Last updated
10/20/2020
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