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General NPI Number Information
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NPI Number | 1225257710
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Entity Type | Organization
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Legal Business Name | VALLE MEDICAL OFFICE PSC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 136 BDA CABAN
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City | AGUADILLA
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State | PR
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Zip | 00603-9465
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Country | US
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Telephone | 787-997-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 136 BDA CABAN
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City | AGUADILLA
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State | PR
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Zip | 00603-9465
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Country | US
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Telephone | 787-997-1111
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Fax |
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Authorized Official
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Title or Position | FACTURADORA
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Name | DARITZA SANCHEZ SANTANA
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Credential |
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Telephone | 787-314-3431
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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 | 16009
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License Number State | PR
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