Healthcare Provider Details

I. General information

NPI: 1851596407
Provider Name (Legal Business Name): DEPATMENT OF VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CALLE CASIA
SAN JUAN PR
00921-3200
US

IV. Provider business mailing address

ALEJANDRINO RD. FONTAINEBLEU PLAZA APT..#1304
GUAYNABO PR
00969-0969
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone: 787-287-6019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number4767
License Number StatePR

VIII. Authorized Official

Name: DR. RAFAEL RAMIREZ
Title or Position: CENTER DIRECTOR
Credential: MD
Phone: 787-641-7582