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General NPI Number Information
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NPI Number | 1427104579
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Entity Type | Individual
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Provider Name | JOSE LUIS VICENS-SALGADO M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4 FLOR GERENA DELGADO MEDICAL BUILDING
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City | HUMACAO
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State | PR
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Zip | 00792
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Country | US
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Telephone | 787-285-5092
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Fax |
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Provider Business Mailing Address
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Address Line | 44 CALLE HIGUERETA CIUDAD JARDIN
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City | GURABO
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State | PR
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Zip | 00778-9650
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Country | US
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Telephone | 787-712-4914
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 10848
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License Number State | PR
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