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General NPI Number Information
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NPI Number | 1851758361
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Entity Type | Organization
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Legal Business Name | RV MEDICAL PSC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | CARR 3 KM 85.5 BO CANDELERO ARRIBA OFICINA 2 EDIFICIO PLAZA DEL MAR
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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 | 787-850-6654
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Fax | 787-719-4677
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Provider Business Mailing Address
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Address Line | HC 4 BOX 19741
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City | GURABO
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State | PR
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Zip | 00778-8840
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Country | US
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Telephone | 787-850-6654
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Fax | 787-719-4677
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROBERTO VELEZ DE JESUS
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Credential | M.D.
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Telephone | 787-850-6654
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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 | 6182
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License Number State | PR
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