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General NPI Number Information
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NPI Number | 1043715287
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Entity Type | Organization
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Legal Business Name | VIP MEDICAL
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | L2 CALLE 7 URB SAN FERNANDO
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City | TOA ALTA
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State | PR
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Zip | 00953
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Country | US
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Telephone | 787-870-4704
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Fax | 787-870-3756
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Provider Business Mailing Address
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Address Line | P.O. BOX 1212
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City | TOA ALTA
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State | PR
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Zip | 00954-1212
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Country | US
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Telephone | 787-870-4704
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Fax | 787-870-3756
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JANIZABETH VAZQUEZ
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Credential |
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Telephone | 787-554-8129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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