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General NPI Number Information
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NPI Number | 1962628909
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Entity Type | Organization
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Legal Business Name | CENTRO VACUNACION DR REYES CABEZA
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | URB. SAN ANTONIO 539 RAMAL CARR 2
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City | PONCE
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State | PR
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Zip | 00728-0000
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Country | US
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Telephone | 787-842-8945
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Fax | 787-290-4472
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Provider Business Mailing Address
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Address Line | 1575 AVE MUNOZ RIVERA PMB 281
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City | PONCE
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State | PR
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Zip | 00717-0211
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Country | US
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Telephone | 787-842-8945
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Fax | 787-290-4472
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VICTOR REYES CABEZA
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Credential | MD
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Telephone | 787-842-8945
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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 | 8809
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License Number State | PR
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