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General NPI Number Information
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NPI Number | 1043726490
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Entity Type | Organization
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Legal Business Name | VACUNAS PLUS DE CAROLINA
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | VILLA CAROLINA 7-27 AVE ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-528-0002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3583
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City | GUAYNABO
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State | PR
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Zip | 00970-3583
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Country | US
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Telephone | 787-528-0002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS JAVIER PEREZ
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Credential |
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Telephone | 787-528-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SOL-11845-K9R7
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License Number State | PR
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