Provider Demographics
NPI:1356646491
Name:CENTRO VACUNACION
Entity Type:Organization
Organization Name:CENTRO VACUNACION
Other - Org Name:CENTRO MEDICO CENTRAL COTO LAUREL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:OCASIO
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:787-848-7532
Mailing Address - Street 1:103 CALLE CENTRAL
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2103
Mailing Address - Country:US
Mailing Address - Phone:787-848-7532
Mailing Address - Fax:787-842-7836
Practice Address - Street 1:103 CALLE CENTRAL
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2103
Practice Address - Country:US
Practice Address - Phone:787-848-7532
Practice Address - Fax:787-848-7532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care