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General NPI Number Information
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NPI Number | 1194876458
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Entity Type | Individual
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Provider Name | ENID M. VARGAS M.T.
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BO. CUEVAS CARR 385 KM0.5 SUITE 100
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City | PENUELAS
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State | PR
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Zip | 00624
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Country | US
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Telephone | 787-836-2669
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Fax | 787-836-4554
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Provider Business Mailing Address
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Address Line | URB. SANTA MARIA- HACIENDA CAMACHO G6
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City | GUAYANILLA
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State | PR
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Zip | 00656-1515
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Country | US
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Telephone | 787-835-2331
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Fax | 787-836-4554
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246QL0900X
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Taxonomy Name | Laboratory Management Specialist/Technologist
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License Number | 1963
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License Number State | PR
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