# POLICLINICA FAMILIAR SHALOM INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SERVICIOS PREVENTIVOS DE SALUD DE MAYAGUEZ PUERTO RICO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619580321
- **Authorized official:** VIVIAN FELICIANO NIEVES (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (787) 896-1850

## Contact information

- **Practice address:** 25 CALLE MENDEZ VIGO W, MAYAGUEZ, PR 00680-6756
- **Practice address phone:** (787) 896-1850
- **Practice address fax:** (787) 280-9497
- **Mailing address:** PO BOX 903, QUEBRADILLAS, PR 00678-0903
- **Mailing address phone:** (787) 896-1850
- **Mailing address fax:** (787) 280-9497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2020
- **Last updated:** 08/24/2020