Healthcare Provider Details

I. General information

NPI: 1225214372
Provider Name (Legal Business Name): VACUNACION AL DIA NINOS Y ADULTOS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILLA CAROLINA CALLE 18 BLQ. 22 #2
CAROLINA PR
00985
US

IV. Provider business mailing address

VILLA CAROLINA 18TH STREET BLQ 22 # 2
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-701-5860
  • Fax:
Mailing address:
  • Phone: 787-701-5860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA DE LOURDES RIVERA-HANCE
Title or Position: ENFERMERA GRADUADA/ADMINISTRADORA
Credential: RN
Phone: 787-701-5860