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General NPI Number Information
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NPI Number | 1346678711
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Entity Type | Organization
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Legal Business Name | VACUNAS PLUS PONCE, INC
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | CALLE FERROCARRIL ESQUINA MARINA 9105 SEGUNDO PISO EDIF ORENGO MEDICAL BUILDING
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-624-9994
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3583
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City | GUAYNABO
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State | PR
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Zip | 00970-3583
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Country | US
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Telephone | 787-624-9994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAMARA VALLS
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Credential |
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Telephone | 787-624-9994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | PR
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