Healthcare Provider Details

I. General information

NPI: 1568951853
Provider Name (Legal Business Name): VIVIANA BARQUET MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1789 CARR 21 STE 310
SAN JUAN PR
00921-3337
US

IV. Provider business mailing address

1789 CARR 21 STE 310
SAN JUAN PR
00921-3337
US

V. Phone/Fax

Practice location:
  • Phone: 787-781-8182
  • Fax:
Mailing address:
  • Phone: 787-781-8182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number2023014438
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number23502
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: