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General NPI Number Information
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NPI Number | 1922375674
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Entity Type | Organization
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Legal Business Name | XANOGENE LLC
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 300 AVE FELISA RINCON LAS VISTAS SHOPPING VILLAGE
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City | SAN JUAN
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State | PR
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Zip | 00926-6088
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Country | US
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Telephone | 787-761-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 300 FELISA RINCON LAS VISTAS SHOPPING VILLAGE
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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 | 787-761-5880
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PROF. JORGE B VAZQUEZ
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Credential |
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Telephone | 787-761-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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