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NPI Code Detail

MEDICARE: VIVIAN VIVAS COLON

MEDICARE: VIVIAN VIVAS COLON
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
12355S0801XSpeech-Language Assistant1798PR

General Provider Information

NPI Number : 1508194101
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVIAN VIVAS COLON
Provider Business Mailing Address
First Line : C/DIEGO VELAZQUEZ
Second Line : D.42 URB. EL CONQUISTADOR
City : TRUJILLO ALTO
State : PR
Zip : 00976
Country : US
Telephone Number : 787-923-0332
Fax Number :
Provider Business Practice Location Address
First Line : 759 AVE AVELINO VICENTE
Second Line :
City : SAN JUAN
State : PR
Zip : 00909-2538
Country : US
Telephone Number : 787-724-5559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2009
Last Update Date : 11/20/2009

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Directions to “ VIVIAN VIVAS COLON ” Practice Location

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