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General NPI Number Information
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NPI Number | 1285684217
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Entity Type | Individual
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Provider Name | JOSE WILFREDO VALLE-OLIVERAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BALDORIOTY ST. A-9
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City | NAGUABO
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State | PR
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Zip | 00718
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Country | US
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Telephone | 787-874-0460
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Fax | 787-874-0125
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | NAGUABO
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State | PR
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Zip | 00718-0548
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Country | US
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Telephone | 787-874-0460
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Fax | 787-874-0125
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 12243
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License Number State | PR
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