Organization
PREMIUM HEALTH GROUP CLINIC LLC
Active
Parent organization
PREMIUM HEALTH GROUP CLINIC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIUM HEALTH GROUP CLINIC LLC
Authorized official
LUZ VILLANUEVA (CEO)
(787) 253-1101
Entity
Organization
Contact information
Practice address
LAGUNA GARDENS SHOPPING CENTER, SUITE 101A, CAROLINA, PR 00979
(787) 444-4908
Mailing address
LAGUNA GARDENS SHOPPING CENTER, SUITE 101A, CAROLINA, PR 00979
(787) 444-4908
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
06/03/2019
Last updated
05/07/2020
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