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General NPI Number Information
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NPI Number | 1285927152
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Entity Type | Organization
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Legal Business Name | VACCINATION SERVICES INC
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 100 CALLE CARAZO
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City | GUAYNABO
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State | PR
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Zip | 00969-5717
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Country | US
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Telephone | 787-720-8783
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3768
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City | GUAYNABO
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State | PR
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Zip | 00970-3768
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Country | US
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Telephone | 787-720-8783
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. NESTOR E PEREZ SR.
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Credential | M.D.
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Telephone | 787-720-8783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 8246
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License Number State | PR
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