Provider Demographics
NPI:1245552272
Name:VENUS GARDENS MANOR CORP.
Entity type:Organization
Organization Name:VENUS GARDENS MANOR CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-748-7242
Mailing Address - Street 1:PO BOX 34243
Mailing Address - Street 2:FT. BUCHANAN
Mailing Address - City:FORT BUCHANAN
Mailing Address - State:PR
Mailing Address - Zip Code:00934-0243
Mailing Address - Country:US
Mailing Address - Phone:787-748-7242
Mailing Address - Fax:
Practice Address - Street 1:671 CALLE ACUARIO
Practice Address - Street 2:URB. VENUS GARDENS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4814
Practice Address - Country:US
Practice Address - Phone:787-748-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR09-10-160 SJ261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR09-10-160 SJOtherLICENCIA SALUD PR