Healthy Body Factory, Inc
Organization Active NPI General Practice Physician · Lajas, PR
NPI 1639636541 · NPPES record last updated Feb 27, 2019
Key facts
- NPI
- 1639636541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- HEALTHY BODY FACTORY, INC
- Practice address
- Carr 315 KM 1.3 Bo Sabana Yeguas
Lajas, PR 00667-9066 - Phone
- (787) 616-2373
- Fax
- (787) 899-2836
- NPI assigned
- Feb 27, 2019
- Organization subpart
- Yes
- Parent organization (as reported)
- HEALTHY BODY FACTORY INC.
Authorized official
- Name
- Lizmary Nazario-Irizarry, M.D.
- Title
- President
- Phone
- (787) 616-2373
Practitioners 1
-
Lizmary Nazario Irizarry, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200908001232 | PR | Part B Supplier - Clinic/Group Practice | 1658799648 |
Receives reassigned benefits from 1 practitioner Practice locations: Lajas, PR |
National Provider Directory
- Part of
- Healthy Body Factory Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
Carr 315 KM 1.3 Bo Sabana Yeguas
Lajas, PR 00667-9066
Mailing address
HC 1 Box 7365
Lajas, PR 00667-9066
Phone (787) 616-2373
Other providers in Lajas, PR
- Norman Gonzalez Casiano
- Enid Gonzalez-Pagan
- Dennis Joel Gonzalez
- Carolina Thais Gutierrez Pacheco
- Andres Ivan Gutierrez
- Taryn Henriquez
- Myrna Rosa Hernandez Flores
- Yaritza Hernandez Lopez
- Kevin Hernandez Montalvo
- Marian Teresa Homs
All providers in Lajas, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.