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NPI Code Detail

MEDICARE: VMV NEFROLOGY & TRANSPLANT GROUP PSC

MEDICARE: VMV NEFROLOGY & TRANSPLANT GROUP PSC
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
1207RN0300XNephrology Physician17496PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117496OTHERPRMD LICENSE

General Provider Information

NPI Number : 1871048918
Entity Type Code : Organization
Provider Name (Legal Business Name) : VMV NEFROLOGY & TRANSPLANT GROUP PSC
Provider Business Mailing Address
First Line : 443 PASEO DORADO
Second Line : CUIDAD JARDIN
City : CANOVANAS
State : PR
Zip : 00729-9890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : AVE PONCE DE LEON
Second Line : PDA 37 1/2
City : SAN JUAN
State : PR
Zip : 00915-3959
Country : US
Telephone Number : 787-758-2500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : VERONICA MEZA VENENCIA
Credential : MD
Telephone Number : 787-587-9983
Provider Enumeration Date : 08/18/2016
Last Update Date : 02/13/2023

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