Organization
CENTRO CLINICO DE VEGA ALTA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARITZA TRINIDAD REYES MD (PRESIDENT)
(787) 617-6141
Entity
Organization
Contact information
Practice address
CALLE MUNOZ RIVERA NUM 5A, VEGA ALTA, PR 00692
(787) 883-5917
Mailing address
138 WINSTON CHURCHILL AVENUE, EL SENORIAL MAIL STATION 641, SAN JUAN, PR 00926
(787) 883-5917
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/15/2012
Last updated
08/21/2014
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