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General NPI Number Information
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NPI Number | 1730806100
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Entity Type | Organization
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Legal Business Name | ABC VACUNA T INC
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | A4 AVE DEGETAU
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City | CAGUAS
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State | PR
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Zip | 00725-4340
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Country | US
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Telephone | 787-501-8042
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9525
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City | CAGUAS
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State | PR
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Zip | 00726-9525
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Country | US
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Telephone | 787-501-8042
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | MISS BARBARA DE LOURDES BRAVO
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Credential | RN
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Telephone | 787-932-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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