Provider Demographics
NPI:1053286252
Name:INNOVATIVE HEALTH CARE LLC
Entity type:Organization
Organization Name:INNOVATIVE HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDERO QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:TEC
Authorized Official - Phone:787-590-6321
Mailing Address - Street 1:PO BOX 1539
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1539
Mailing Address - Country:US
Mailing Address - Phone:787-590-6321
Mailing Address - Fax:
Practice Address - Street 1:VISTAS DE LAS PALMAS 16, CARR 111 KM 3.1 BO PUEBLO
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-590-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty