Organization
VIDA PLUS MEDICAL CLINIC, CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH S. CAMPOS M.D. (PRESIDENT)
(787) 731-4949
Entity
Organization
Contact information
Practice address
AVE. FCO. CORRETJER NARVAEZ, LOTE 21, CALLE E,, EDF. CARIBBEAN CINEMAS, SUITE 201, GUAYNABO, PR 00970-3925
(787) 731-4949
Mailing address
AVE. FCO. CORRETJER NARVAEZ, LOTE 21, CALLE E,, EDF. CARIBBEAN CINEMAS, SUITE 201, GUAYNABO, PR 00970
(787) 731-4949
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
302R00000X
Health Maintenance Organization
13839
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021499
PTAN
PR
Enumeration date
06/06/2012
Last updated
02/03/2015
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