Healthcare Provider Details

I. General information

NPI: 1750429791
Provider Name (Legal Business Name): MARIA ARANDA VICENTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL SAN LUCAS CARR 14 AVE TITO CASTRO 917
PONCE PR
00721
US

IV. Provider business mailing address

PO BOX 9036
PONCE PR
00732-9036
US

V. Phone/Fax

Practice location:
  • Phone: 787-396-6967
  • Fax:
Mailing address:
  • Phone: 787-840-1376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8320
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: