Individual
NELLY VIDAL DE JESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1503 CALLE PROF AUGUSTO RODRIGUEZ STE 600, SAN JUAN, PR 00909-2275
(787) 497-0800
(787) 982-6464
Mailing address
1503 CALLE PROF AUGUSTO RODRIGUEZ STE 600, SAN JUAN, PR 00909-2275
(787) 497-0800
(787) 982-6464
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4041170
PR
Other
Enumeration date
07/27/2017
Last updated
07/21/2022
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