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General NPI Number Information
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NPI Number | 1245686757
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Entity Type | Organization
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Legal Business Name | VACUNAS BRIGHT CENTER INC.
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 936 CALLE DOLORES MARCHAND VILLAS DE RIO CANAS
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City | PONCE
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State | PR
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Zip | 00728
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Country | US
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Telephone | 787-432-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 936 CALLE DOLORES MARCHAND VILLAS DE RIO CANAS
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City | PONCE
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State | PR
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Zip | 00728
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Country | US
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Telephone | 787-298-2795
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. DANIA L COLON
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Credential |
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Telephone | 787-298-2795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 371932
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License Number State | PR
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