Organization
ELITE MEDICAL CLINIC OF PR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YADIRA DOMINGUEZ VAZQUEZ MD (PRESIDENT)
(787) 239-7575
Entity
Organization
Contact information
Practice address
400 AVE DOMENECH STE 412, LAS AMERICAS PROFESSIONAL CENTER, SAN JUAN, PR 00918-3748
(787) 945-0767
Mailing address
400 AVE DOMENECH STE 412, LAS AMERICAS PROFESSIONAL CENTER, SAN JUAN, PR 00918-3748
(787) 945-0767
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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