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General NPI Number Information
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NPI Number | 1316051378
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Entity Type | Organization
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Legal Business Name | JESSICA VILLAFANE PAGAN
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 500 CARR 149 STE 6
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City | CIALES
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State | PR
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Zip | 00638-9661
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Country | US
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Telephone | 787-871-0470
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Fax | 787-871-0470
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Provider Business Mailing Address
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Address Line | 500 CARR 149 STE 6
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City | CIALES
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State | PR
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Zip | 00638-9661
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Country | US
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Telephone | 787-871-0470
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Fax | 787-871-0470
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Authorized Official
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Title or Position | TECNOLOGA MEDICA
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Name | MS. JESSICA VILLAFANE
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Credential | LCD
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Telephone | 787-871-0470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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