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General NPI Number Information
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NPI Number | 1295041317
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Entity Type | Individual
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Provider Name | MR. VICTOR L MAISONET
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Gender | Male
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Dates
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Enumeration Date | 08/26/2010
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Last Update Date | 08/26/2010
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Provider Practice Location Address
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Address Line | 213 URB VALLES DE ANASCO
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City | ANASCO
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State | PR
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Zip | 00610-9601
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Country | US
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Telephone | 787-882-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 213 URB VALLES DE ANASCO
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City | ANASCO
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State | PR
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Zip | 00610-9601
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Country | US
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Telephone | 787-882-7900
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Fax |
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | 4196
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License Number State | PR
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