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General NPI Number Information
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NPI Number | 1417507138
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Entity Type | Individual
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Provider Name | JORGE ALBERTO VARGAS VENERO
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Gender | Male
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Dates
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Enumeration Date | 09/14/2019
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Last Update Date | 09/14/2019
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Provider Practice Location Address
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Address Line | 650 AVE LUIS MUNOZ RIVERA STE 701
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City | SAN JUAN
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State | PR
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Zip | 00918-4110
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Country | US
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Telephone | 787-523-1212
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE 24 O-2 ALTURAS DE FLAMBOYAN
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City | BAYAMON
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State | PR
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Zip | 00959
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Country | US
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Telephone | 787-464-8042
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6426
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License Number State | PR
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