Healthcare Provider Details

I. General information

NPI: 1750687414
Provider Name (Legal Business Name): DEPARTMENT OF VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CASIA 10
SAN JUAN PR
00926-0926
US

IV. Provider business mailing address

10 CALLE CASIA
SAN JUAN PR
00921-3200
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-641-7582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA L REYES
Title or Position: CHIEF PSYCHIATRY
Credential: M.D
Phone: 787-641-7582