Provider Demographics
NPI:1043726490
Name:VACUNAS PLUS DE CAROLINA
Entity type:Organization
Organization Name:VACUNAS PLUS DE CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-528-0002
Mailing Address - Street 1:PO BOX 3583
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3583
Mailing Address - Country:US
Mailing Address - Phone:787-528-0002
Mailing Address - Fax:
Practice Address - Street 1:VILLA CAROLINA
Practice Address - Street 2:7-27 AVE ROBERTO CLEMENTE
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-528-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRSOL-11845-K9R7261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center