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General NPI Number Information
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NPI Number | 1710303433
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Entity Type | Organization
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Legal Business Name | GRUPO GINECOLOGICO SANTORO VALE
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 107 ORTEGON ST. CAPARRA GALLERY SUITE 312
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-600-7798
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Fax | 787-754-0935
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Provider Business Mailing Address
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Address Line | LA CUMBRE BOX 263 267 SIERRA MORENA ST
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-600-7798
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Fax | 787-754-0935
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YARI VALE- MORENO
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Credential | M.D.
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Telephone | 787-672-8086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 16059
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License Number State | PR
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