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NPI Code Detail

MEDICARE: BELLA VISTA POLICLINIC, INC

MEDICARE: BELLA VISTA POLICLINIC, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center10 CNC 99-331PR

General Provider Information

NPI Number : 1043246788
Entity Type Code : Organization
Provider Name (Legal Business Name) : BELLA VISTA POLICLINIC, INC
Provider Business Mailing Address
First Line : PO BOX 850
Second Line :
City : MAYAGUEZ
State : PR
Zip : 00681-0850
Country : US
Telephone Number : 787-834-6161
Fax Number : 787-805-4635
Provider Business Practice Location Address
First Line : AVE HOSTOS
Second Line : NUMBER 770
City : MAYAGUEZ
State : PR
Zip : 00682-6353
Country : US
Telephone Number : 787-834-6161
Fax Number : 787-805-4635
Authorized Official
Title or Position : ADMINISTRATIVE ASISTANT
Name : MR. ENRIQUE RIVERA
Credential :
Telephone Number : 787-834-6161
Provider Enumeration Date : 06/24/2006
Last Update Date : 08/22/2020

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Directions to “BELLA VISTA POLICLINIC, INC ” Practice Location

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