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Organization

LA VIDA MEDICAL GROUP HATILLO PT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA I MATOS (BILLING MANAGER)
(787) 878-8155
Entity
Organization

Contact information

Practice address
549 CALLE DEL MAR, SUITE 304, HATILLO, PR 00659-2869
(787) 878-8802
(787) 881-4312
Mailing address
549 CALLE DEL MAR, SUITE 304, HATILLO, PR 00659-2869
(787) 878-8802
(787) 881-4312

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
707
PR

Other

Enumeration date
04/07/2008
Last updated
04/07/2008
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