# VACUNAS DEL SUR INCORPORADO

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

## Provider details

- **NPI number:** 1295385508
- **Authorized official:** MARCOS RIVERA (PRESIDENT)
- **Authorized official phone:** (787) 425-9012

## Contact information

- **Practice address:** AVE UNIVERSIDAD INTERAMERICANA 187 SUITE 109, SAN GERMAN, PR 00683
- **Practice address phone:** (787) 955-5525
- **Mailing address:** PO BOX 7763, PONCE, PR 00732-7763
- **Mailing address phone:** (787) 425-9012

## Taxonomy

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

## Other

- **Enumeration date:** 09/18/2019
- **Last updated:** 09/18/2019