Provider Demographics
NPI:1023858990
Name:CLINICA VENDRELL LLC
Entity type:Organization
Organization Name:CLINICA VENDRELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPIETARIO
Authorized Official - Prefix:
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:JORGE
Authorized Official - Last Name:VENDRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-344-8003
Mailing Address - Street 1:956 VILLAS DE RIO CANAS
Mailing Address - Street 2:CALLE FRANCISCO COIMBRE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-344-8003
Mailing Address - Fax:787-844-3143
Practice Address - Street 1:2525 AVE EDUARDO RUBERTE STE 111
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1712
Practice Address - Country:US
Practice Address - Phone:787-344-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service