# BELLA VISTA POLICLINIC, INC

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

## Provider details

- **NPI number:** 1043246788
- **Authorized official:** MR. ENRIQUE RIVERA (ADMINISTRATIVE ASISTANT)
- **Authorized official phone:** (787) 834-6161

## Contact information

- **Practice address:** AVE HOSTOS, NUMBER 770, MAYAGUEZ, PR 00682-6353
- **Practice address phone:** (787) 834-6161
- **Practice address fax:** (787) 805-4635
- **Mailing address:** PO BOX 850, MAYAGUEZ, PR 00681-0850
- **Mailing address phone:** (787) 834-6161
- **Mailing address fax:** (787) 805-4635

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 10 CNC 99-331 | PR | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 08/22/2020