# CENTRO DE VACUNACION VEGA BAJA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003254582
- **Authorized official:** DR. IVAN A CEREZO M.D (DOCTOR)
- **Authorized official phone:** (787) 855-0031

## Contact information

- **Practice address:** 2 AVE. \#107 OFFICE, WILMA N. VAZQUEZ, VEGA BAJA, PR 00693
- **Practice address phone:** (787) 855-0031
- **Mailing address:** 52 CALLE PALMER, TOA ALTA, PR 00953-2428
- **Mailing address phone:** (787) 855-0031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 9816 | PR | Yes |

## Other

- **Enumeration date:** 06/06/2013
- **Last updated:** 06/06/2013