Provider Demographics
NPI:1700161684
Name:CENTRO TERAPEUTICO VIMAR, PSC
Entity Type:Organization
Organization Name:CENTRO TERAPEUTICO VIMAR, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSPHL
Authorized Official - Phone:787-276-8123
Mailing Address - Street 1:27-16 AVE ROBERTO CLEMENTE
Mailing Address - Street 2:VILLA CAROLINA
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985-5420
Mailing Address - Country:US
Mailing Address - Phone:787-276-8123
Mailing Address - Fax:
Practice Address - Street 1:27-16 AVE ROBERTO CLEMENTE
Practice Address - Street 2:VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5420
Practice Address - Country:US
Practice Address - Phone:787-276-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR730174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty