Healthcare Provider Details

I. General information

NPI: 1558974626
Provider Name (Legal Business Name): VACUNAS PLUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLAZA SUITE 308-B
BAYAMON PR
00959
US

IV. Provider business mailing address

PO BOX 3583
GUAYNABO PR
00970-3583
US

V. Phone/Fax

Practice location:
  • Phone: 787-528-0002
  • Fax:
Mailing address:
  • Phone: 787-528-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS JAVIER PEREZ
Title or Position: PRESIDENT
Credential:
Phone: 787-528-0002