Healthcare Provider Details

I. General information

NPI: 1275729188
Provider Name (Legal Business Name): VIVIAN JANNETTE JOGLAR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO MACHUELO CARRETERA 14 HOSPITAL STQ FORENSE PONCE
PONCE PR
00731
US

IV. Provider business mailing address

URBANIZACION VILLA DEL CARMEN # 1004 CALLE SALERNO
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-0101
  • Fax:
Mailing address:
  • Phone: 787-844-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number25427
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: