Organization
PREMIUM WELLNESS INFUSION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVELISSE HERNANDEZ (VP)
(787) 966-7169
Entity
Organization
Contact information
Practice address
LAGUNA GARDENS SHOPPING CENTER SUITE 101-A, CAROLINA, PR 00979
(787) 966-7169
Mailing address
LAGUNA GARDENS SHOPPING CENTER SUITE 101-A, CAROLINA, PR 00979
(787) 966-7169
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
03/03/2021
Last updated
03/04/2021
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