Provider Demographics
NPI:1245686757
Name:VACUNAS BRIGHT CENTER INC.
Entity type:Organization
Organization Name:VACUNAS BRIGHT CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-298-2795
Mailing Address - Street 1:936 CALLE DOLORES MARCHAND
Mailing Address - Street 2:VILLAS DE RIO CANAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-298-2795
Mailing Address - Fax:
Practice Address - Street 1:936 CALLE DOLORES MARCHAND
Practice Address - Street 2:VILLAS DE RIO CANAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-432-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR302R00000X
PR371932302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization