# OFICINA DE VACUNACION SANTA JUANITA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** IVAN CEREZO DE LA ROSA
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760724645
- **Authorized official:** PALMIRA RUIZ (SECRETARY)
- **Authorized official phone:** (787) 780-0391

## Contact information

- **Practice address:** DB35 CALLE DAMASCO, URB SANTA JUANITA, BAYAMON, PR 00956
- **Practice address phone:** (787) 780-0391
- **Practice address fax:** (787) 787-6403
- **Mailing address:** DB35 CALLE DAMASCO, URB SANTA JUANITA, BAYAMON, PR 00956-5313
- **Mailing address phone:** (787) 780-0391
- **Mailing address fax:** (787) 787-6403

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 522463 | PR | Yes |

## Other

- **Enumeration date:** 03/19/2013
- **Last updated:** 05/07/2013