# BELLA VISTA POLICLINIC, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BELLA VISTA POLICLINIC, INC
- **Other names:** Bella Vista ENT Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1205187697
- **Legal business name:** BELLA VISTA POLICLINIC, INC
- **Authorized official:** MR. ENRIQUE RIVERA MBA (CFO)
- **Authorized official phone:** (787) 652-6031

## Contact information

- **Practice address:** AVE HOSTOS, NUMBER 770, MAYAGUEZ, PR 00681
- **Practice address phone:** (787) 652-6031
- **Practice address fax:** (787) 805-3705
- **Mailing address:** AVE HOSTOS, NUMBER 770, MAYAGUEZ, PR 00681
- **Mailing address phone:** (787) 652-6031
- **Mailing address fax:** (787) 805-3705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 200394 | PR | Yes |

## Other

- **Enumeration date:** 09/25/2012
- **Last updated:** 09/25/2012