Organization
EASTERN PUERTO RICO DIABETES CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRIAM ZAHYDEE ALLENDE-VIGO MD (OWNER)
(787) 852-5313
Entity
Organization
Contact information
Practice address
18 CALLE JORGE FRANCESHI, HUMACAO, PR 00791-3915
(787) 852-5313
Mailing address
PO BOX 364246, SAN JUAN, PR 00936-4246
(787) 852-5313
(787) 285-7319
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04962
PR LICENSE BOARD
PR
Enumeration date
11/29/2017
Last updated
11/29/2017
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