# CENTRO DE VACUNACION BORINQUEN

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

## Provider details

- **NPI number:** 1255757084
- **Authorized official:** ALEYDA IVETTE GARCIA RN (ADMINISTRATOR)
- **Authorized official phone:** (787) 819-3829

## Contact information

- **Practice address:** CARR. 107 KM 1.1, BO. BORINQUEN, AGUADILLA, PR 00603
- **Practice address phone:** (787) 819-3829
- **Practice address fax:** (787) 819-3829
- **Mailing address:** PO BOX 4319, AGUADILLA, PR 00605-4319
- **Mailing address phone:** (787) 819-3829
- **Mailing address fax:** (787) 819-3829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/18/2014
- **Last updated:** 03/18/2014