Individual
WILDALIS NOVOA-VIDOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
BO SANTA ROSA CALLE LAS VIOLETAS INT FINCA#1, VEGA ALTA, PR 00692
(787) 225-5747
Mailing address
PO BOX 532, VEGA ALTA, PR 00692-0532
(787) 225-5747
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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