Individual
IVAN LORENZO VIERA- SAN MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN
Contact information
Practice address
78 PLAZA FABIOLA, ESTANCIAS DE CERRO GORDO, VEGA ALTA, PR 00692-9125
(787) 717-2568
Mailing address
78 PLAZA FABIOLA, ESTANCIAS DE CERRO GORDO, VEGA ALTA, PR 00692-9125
(787) 717-2568
Taxonomy
Speciality
Code
Description
License number
State
364SG0600X
Gerontology Clinical Nurse Specialist
Primary
E1779
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1187382
DRIVER LICENSE
PR
Enumeration date
02/22/2019
Last updated
02/22/2019
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