Healthcare Provider Details

I. General information

NPI: 1871048918
Provider Name (Legal Business Name): VMV NEFROLOGY & TRANSPLANT GROUP PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE PONCE DE LEON PDA 37 1/2
SAN JUAN PR
00915-3959
US

IV. Provider business mailing address

443 PASEO DORADO CUIDAD JARDIN
CANOVANAS PR
00729-9890
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number17496
License Number StatePR

VIII. Authorized Official

Name: VERONICA MEZA VENENCIA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-587-9983