Provider Demographics
NPI:1700457785
Name:RED CRYSTAL HOLDINGS LLC
Entity type:Organization
Organization Name:RED CRYSTAL HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:VELEZ WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-357-1789
Mailing Address - Street 1:PONCE DE LEON, SAN AGUSTIN #3
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5121
Mailing Address - Country:US
Mailing Address - Phone:787-314-8430
Mailing Address - Fax:
Practice Address - Street 1:PLAZA DEL MERCADO LOLITA MONTALVO CORDERO
Practice Address - Street 2:CALLE CARBONELL 12. SUITE 10
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-0000
Practice Address - Country:US
Practice Address - Phone:939-357-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care