Healthcare Provider Details

I. General information

NPI: 1932500758
Provider Name (Legal Business Name): VSG PULMONOLOGY MEDICINE PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 CALLE YANGTZE RIO PIEDRAS HEIGHTS
SAN JUAN PR
00926
US

IV. Provider business mailing address

58 CALLE AQUAMARINA
SAN JUAN PR
00926-7070
US

V. Phone/Fax

Practice location:
  • Phone: 787-244-8224
  • Fax: 888-614-7084
Mailing address:
  • Phone: 787-244-8224
  • Fax: 787-790-6671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number13982
License Number StatePR

VIII. Authorized Official

Name: VIRIDIANA SALINAS GONZALEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-410-7044