MEDICARE: SAN JUAN VAMC

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
1	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1730130915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN JUAN VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94469
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4469
Country	:	US
Telephone Number	:	866-793-4591
Fax Number	:

Provider Business Practice Location Address
First Line	:	HATO ABAJO WARD PR #2
Second Line	:	INT PR 600 KM 78
City	:	ARECIBO
State	:	PR
Zip	:	00612-9998
Country	:	US
Telephone Number	:	866-793-4591
Fax Number	:

Authorized Official
Title or Position	:	NPI TEAM
Name	:	ERIN POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	04/30/2026

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Directions to “SAN JUAN VAMC ” Practice Location

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