Healthcare Provider Details

I. General information

NPI: 1386037323
Provider Name (Legal Business Name): YARIMAR VARGAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 03/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 CALLE CHIPRE EXTENSION SAN LUIS
AIBONITO PR
00705-3146
US

IV. Provider business mailing address

3 CALLE CHIPRE EXTENSION SAN LUIS
AIBONITO PR
00705-3146
US

V. Phone/Fax

Practice location:
  • Phone: 787-449-7803
  • Fax:
Mailing address:
  • Phone: 787-449-7803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberPCVTE 4443
License Number StatePR

VIII. Authorized Official

Name: MRS. YARIMAR VARGAS
Title or Position: PRESIDENTA
Credential:
Phone: 787-449-7803