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General NPI Number Information
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NPI Number | 1093234544
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Entity Type | Organization
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Legal Business Name | CENTRO TERAPEUTICO GLORIMAR VEGA INC.
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | CARR 2 INTERIOR KIL 92.3 BARRIO PUENTE PENA
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City | CAMUY
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State | PR
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Zip | 00627
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Country | US
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Telephone | 787-680-1200
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Fax | 787-680-1200
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Provider Business Mailing Address
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Address Line | HC 5 BOX 30395
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City | CAMUY
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State | PR
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Zip | 00627-9581
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Country | US
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Telephone | 787-378-9807
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Fax | 787-680-1200
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Authorized Official
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Title or Position | OWNER
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Name | GLORIMAR VEGA
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Credential |
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Telephone | 787-378-9807
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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 |
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License Number State |
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