# CENTRO DE VACUNACION POLICLINICA DR. RADAMES MARIN, INC.

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

## Provider details

- **NPI number:** 1992847107
- **Authorized official:** DR. RADAMES MARIN MD (PRESIDENT)
- **Authorized official phone:** (787) 856-0844

## Contact information

- **Practice address:** 61 CALLE COMERCIO, YAUCO, PR 00698-3541
- **Practice address phone:** (787) 856-0844
- **Practice address fax:** (787) 267-5554
- **Mailing address:** PO BOX 1665, YAUCO, PR 00698-1665
- **Mailing address phone:** (787) 856-0844
- **Mailing address fax:** (787) 267-5554

## Taxonomy

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

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 05/07/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10525 | TRIPLE S | PR |