Atlantis Health Care Group Puerto Rico INC
Clinic/Center, End-Stage Renal Disease (ESRD) Treatment in Trujillo Alto, PR. Organization (NPI-2).
NPI number1104907682
StatusActive
Last updated in NPPESSep 9, 2016
Details
- NPI
- 1104907682
- Entity type
- Organization (NPI-2)
- Legal business name
- Atlantis Health Care Group Puerto Rico INC
- Organization subpart
- No
- Enumeration date
- Oct 18, 2006
- Last updated
- Sep 9, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #3 CNC 01-109 | PR | Yes |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #23 CNC 05-260 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #12 CNC 04-126 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #19 CNC 01-107 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #37 CNC 02-166 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #25 CNC 01-108 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | 27 CNC 02-162 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC NUM 36 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC #28 CNC 03-278 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | Lic. #44 CNC12-087 | PR | |
| 261QE0700X | Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | LIC # 46 CNC 13-051 | PR |
Practice location
Calle Aniceto Diaz Interseccion 876Expreso Trujillo Alto
Trujillo Alto, PR 00978
Phone 787-292-7979 · Fax 787-292-7999
Mailing address
Po Box 1350St. Just Station
Saint Just, PR 00978-1350
Phone 787-292-7979 · Fax 787-292-7999
Authorized official
Rubette Harford
President & Ceo
7872927979
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