Healthcare Provider Details

I. General information

NPI: 1497277842
Provider Name (Legal Business Name): METRO PAVIA HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MARINA #38
PONCE PR
00717
US

IV. Provider business mailing address

PO BOX 9976 COTTO STATION
ARECIBO PR
00613
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-8529
  • Fax:
Mailing address:
  • Phone: 787-230-7530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. VIVIAN SOLIVAN
Title or Position: PRESIDENTA
Credential:
Phone: 787-230-7530