Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO LOPEZ (CHIEF PSAS)
(787) 641-7582
Entity
Organization
Contact information
Practice address
10 CALLE CASIA, SAN JUAN PR, SAN JUAN, PR 00921-3200
(787) 641-7582
Mailing address
10 CALLE CASIA, SAN JUAN PR, SAN JUAN, PR 00921-3200
(787) 641-7582
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
CP003225
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C18363
BOARD FOR ORTHOTIST/PROSTHETIC CERTIFICATION
PR
01
—
CFO01075
AMERICAN BOARD FOR CERTIFICATION
PR
01
—
CP003225
AMERICAN BOARD FOR CERTIFICATION
PR
Enumeration date
12/02/2008
Last updated
12/02/2008
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