Healthcare Provider Details

I. General information

NPI: 1881888253
Provider Name (Legal Business Name): AMELIA V. VINAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4AS1 FRAGOSO AVE. VILLA FONTANA
CAROLINA PR
00983
US

IV. Provider business mailing address

497 EMILIANO POL AVE. LA CUMBRE PMB 80
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-1930
  • Fax: 787-276-9174
Mailing address:
  • Phone: 787-720-3783
  • Fax: 787-276-9174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6510
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: