# CENTRO DE VACUNACION

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

## Provider details

- **NPI number:** 1083993745
- **Authorized official:** DR. ROBERTO J GANDARA MD (PRESIDENTE)
- **Authorized official phone:** (787) 552-1219

## Contact information

- **Practice address:** CALLE MUNOZ RIVERA \# 3, CAGUAS, PR 00725-1357
- **Practice address phone:** (787) 552-1219
- **Practice address fax:** (787) 745-0108
- **Mailing address:** P O BOB 1357, CAGUAS, PR 00726-1357
- **Mailing address phone:** (787) 552-1219
- **Mailing address fax:** (787) 745-0108

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/12/2011
- **Last updated:** 08/12/2011