# HCO DR. MANUEL VIZCARRONDO

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

## Provider details

- **NPI number:** 1912242751
- **Authorized official:** DR. MANUEL VIZCARRONDO (DIRECTOR)
- **Authorized official phone:** (787) 824-6392

## Contact information

- **Practice address:** BALDORIOTY, 59, SALINAS, PR 00751
- **Practice address phone:** (787) 824-6392
- **Mailing address:** PO BOX, 2342, GUAYAMA, PR 00785
- **Mailing address phone:** (787) 824-6392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 302F00000X | Exclusive Provider Organization | 8733 | PR | Yes |

## Other

- **Enumeration date:** 12/05/2012
- **Last updated:** 12/06/2012