Organization
CLINICA REUVIVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ISIS M VAZQUEZ-OTERO (ADMINISTRADORA)
(939) 945-8335
Entity
Organization
Contact information
Practice address
1 AVE ALBOLOTE STE 201, GUAYNABO, PR 00969-2807
(939) 945-8335
Mailing address
55 CALLE CASALS, GUAYNABO, PR 00969-1004
(939) 945-8335
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1270055-0014
CERT REGISTRO DE COMERCIANTE
PR
Enumeration date
09/22/2021
Last updated
09/22/2021
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