Organization
AMPEDS PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AITZA REYES SEDA MD (PRESIDENT)
(787) 525-9700
Entity
Organization
Contact information
Practice address
HOSPITAL WILMA VAZQUEZ, DEPARTAMENTO DE PEDIATRIA, VEGA BAJA, PR 00693
(787) 858-1580
(787) 977-8008
Mailing address
1357 ASHFORD AVE, PMB 427, SAN JUAN, PR 00907
(787) 525-9700
(787) 977-8008
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
13281
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13281
LIC
PR
Enumeration date
03/31/2008
Last updated
07/28/2011
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