Provider Demographics
NPI:1023257912
Name:SASTRE, VILMA (RN)
Entity type:Individual
Prefix:
First Name:VILMA
Middle Name:
Last Name:SASTRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE. BORINQUEN BO. OBRERO
Mailing Address - Street 2:APARTADO 14457
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916
Mailing Address - Country:US
Mailing Address - Phone:787-268-4171
Mailing Address - Fax:
Practice Address - Street 1:AVE. BORINQUEN BO. OBRERO
Practice Address - Street 2:APARTADO 14457
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00916
Practice Address - Country:US
Practice Address - Phone:787-268-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4622164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse