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General NPI Number Information
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NPI Number | 1487997292
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Entity Type | Organization
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Legal Business Name | CENTRO DE VACUNACION BUENA FE
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/29/2013
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Provider Practice Location Address
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Address Line | CALLE MARIO BRASCHI#5
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 939-630-2242
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1705
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTORA
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Name | MRS. IRIS VANESSA VELEZ
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Credential | M.D.
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Telephone | 787-432-6579
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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 |
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