Provider Demographics
NPI:1801016399
Name:OLIVIERI-BEAUCHAMP, VILMA N (MD)
Entity Type:Individual
Prefix:DR
First Name:VILMA
Middle Name:N
Last Name:OLIVIERI-BEAUCHAMP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 29134 EDIF.. PRINCIPAL RCM-UPR
Mailing Address - Street 2:RECINTO DE CIENCIAS MEDICAS (UPR-RCM/RADIOLOGIA)
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-777-3535
Mailing Address - Fax:787-777-3855
Practice Address - Street 1:CARR. 22, BO. MANACILLOS, RCM-RADIOLOGIA
Practice Address - Street 2:ADMINISTRACION DE SERVICIOS MEDICOS DE P.R.
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00929-0134
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-3855
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR103732085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10373OtherPUERTO RICO
PR10373OtherPUERTO RICO