| Innovus Therapy Group LLC | |
|
Carr 411 Km 5.0 Bo Jaguey Aguada PR 00602-0060 | |
| (787) 286-7050 | |
| Not Available |
| Full Name | Innovus Therapy Group LLC |
|---|---|
| Speciality | Speech-Language Pathologist |
| Location | Carr 411 Km 5.0 Bo Jaguey, Aguada, Puerto Rico |
| Authorized Official Name and Position | Michelle Lorenzo Gonzalez (PRESIDENTE) |
| Authorized Official Contact | 7872867050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovus Therapy Group LLC Hc 60 Box 15262 Aguada PR 00602-9268 | Innovus Therapy Group LLC Carr 411 Km 5.0 Bo Jaguey Aguada PR 00602-0060 Ph: (787) 286-7050 |
| NPI Number | 1205543881 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 12/14/2023 |
| Certification Date | 12/14/2023 |
| Medicare PECOS PAC ID | 7315311750 |
|---|---|
| Medicare Enrollment ID | O20230324002716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205543881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| 235Z00000X | Speech-language Pathologist | () | Primary |
| Provider Name | Ednie J Ruiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124594726 PECOS PAC ID: 4082021142 Enrollment ID: I20210408000121 |
| Provider Name | Michelle Linaris Lorenzo Gonzalez |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1467935700 PECOS PAC ID: 8224402664 Enrollment ID: I20230324002720 |
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