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General NPI Number Information
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NPI Number | 1033630744
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Entity Type | Organization
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Legal Business Name | PEDIATRICS HEALTHCARE PROVIDERS PSC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | N25 CALLE 3 VILLA VENECIA
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-613-0273
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Fax |
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Provider Business Mailing Address
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Address Line | N25 CALLE 3 VILLA VENECIA
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-613-0273
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. VICTOR M MONTANEZ
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Credential | MD1992764617
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Telephone | 787-447-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 9992
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License Number State |
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