Provider Demographics
NPI:1609448083
Name:VD ALLERGY INSTITUTE LLC.
Entity type:Organization
Organization Name:VD ALLERGY INSTITUTE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALLERGIST IMMUNOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIAZ VIDAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-764-4309
Mailing Address - Street 1:94 RAMAL 842 APT 127
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 AVE DOMENECH STE 408
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3706
Practice Address - Country:US
Practice Address - Phone:787-622-2012
Practice Address - Fax:713-554-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty