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Organization

SECCION A NINOS CON NECESIDADES ESPECIALES

Active
Parent organization
CENTRO DE VACUNACION
Other names
CENTRO PEDIATRICO DE PONCE
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRO DE VACUNACION
Authorized official
MRS. CARMEN R RODRIGUEZ MPA (DIRECTORA EJECUTIVA)
(787) 771-2100
Entity
Organization

Contact information

Practice address
CENTRO PEDIATRICO PONCE 931 CARR 14, BO MACHUELO AVENIDA TITO CASTRO, PONCE, PR 00716-4717
(787) 842-5884
(787) 842-5802
Mailing address
AVENIDA TITO CASTRO 931 CARR. 14 BO. MACHUELO, CENTRO PEDIATRICO DE PONCE, PONCE, PR 00716
(787) 842-5884
(787) 842-5802

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2116-5
ALIADOS
PR
01
433CPP
MEDICO
PR
01
53438
SERVICIOS ALIADOS
PR
01
660433481-4G
GENETICISTA
PR
01
660433481-4P
OFTALMOLOGIA
PR
01
88754
MEDICO
PR
01
S013
PEDIATRA
PR
01
S027
AUDIOLOGIA
PR
Enumeration date
10/17/2008
Last updated
10/17/2008
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