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General NPI Number Information
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NPI Number | 1417090408
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Entity Type | Organization
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Legal Business Name | ZAHIRA VEGA BONILLA
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | CALLE SAN MIGUEL NO 42
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City | GUANICA
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State | PR
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Zip | 00653-1048
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Country | US
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Telephone | 787-821-2350
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Fax | 787-821-2350
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Provider Business Mailing Address
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Address Line | PO BOX 1048
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City | GUANICA
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State | PR
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Zip | 00653-1048
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Country | US
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Telephone | 787-821-2350
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Fax | 787-821-2350
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Authorized Official
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Title or Position | MEDICAL TECNOLOGIST
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Name | MISS ZAHIRA V VEGA
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Credential | 6751
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Telephone | 787-821-2350
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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 | 406
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License Number State | PR
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