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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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