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Organization

MEDWELL MEDICAL MANAGEMENT CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SONIA IVELISSE BONILLA RN (PRESIDENT)
(787) 599-5010
Entity
Organization

Contact information

Practice address
8169 CALLE CONCORDIA STE 310, PONCE, PR 00717-1563
(787) 599-5010
(787) 437-3636
Mailing address
8169 CALLE CONCORDIA STE 310, PONCE, PR 00717-1563
(787) 599-5010
(787) 437-3636

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
261QM2500X
Medical Specialty Clinic/Center
261QP2300X
Primary Care Clinic/Center
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
04/17/2024
Last updated
04/17/2024
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