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General NPI Number Information
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NPI Number | 1114123320
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Entity Type | Organization
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Legal Business Name | POLICLINICA FAMILIAR VEGA BAJA
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | AVENIDA TRIO VEGABAJENO U23 URB EL ROSARIO II
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-858-7073
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Fax | 787-807-1090
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Provider Business Mailing Address
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Address Line | U23 CALLE 7 ROSARIO II
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City | VEGA BAJA
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State | PR
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Zip | 00693-5702
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Country | US
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Telephone | 787-858-7073
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Fax | 787-807-1090
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSE E COLON RIVERA
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Credential | M.D.
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Telephone | 787-858-7073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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