Provider Demographics
NPI:1124593660
Name:VICTOR J. MARIANO INC.
Entity Type:Organization
Organization Name:VICTOR J. MARIANO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JULIO
Authorized Official - Last Name:MARIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-975-2802
Mailing Address - Street 1:PO BOX 1320
Mailing Address - Street 2:
Mailing Address - City:SABANA SECA
Mailing Address - State:PR
Mailing Address - Zip Code:00952-1320
Mailing Address - Country:US
Mailing Address - Phone:787-858-0434
Mailing Address - Fax:
Practice Address - Street 1:ROAD 686 KM18.8 CABO CARIBE #1783-2A
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00694
Practice Address - Country:US
Practice Address - Phone:787-858-0434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty