| Id Care PR LLC | |
|
2049 Calle Luis Xiv Mayaguez PR 00682-7846 | |
| (787) 370-3252 | |
| Not Available |
| Full Name | Id Care PR LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2049 Calle Luis Xiv, Mayaguez, Puerto Rico |
| Authorized Official Name and Position | Ethyann Arlene Garcia Mateo (PRESIDENT) |
| Authorized Official Contact | 7873703252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Care PR LLC 2049 Calle Luis Xiv Mayaguez PR 00682-7846 | Id Care PR LLC 2049 Calle Luis Xiv Mayaguez PR 00682-7846 Ph: (787) 370-3252 |
| NPI Number | 1104799337 |
|---|---|
| Provider Enumeration Date | 09/24/2025 |
| Last Update Date | 09/24/2025 |
| Certification Date | 09/24/2025 |
| Medicare PECOS PAC ID | 3274023692 |
|---|---|
| Medicare Enrollment ID | O20251105001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104799337 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | () | Primary |
| Provider Name | Ethyann a Garcia Mateo |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497114060 PECOS PAC ID: 5698137610 Enrollment ID: I20230810000126 |
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