Organization
CENTRO DE VACUNACION DE AGUADILLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRIAM ACEVEDO (OFFICE MANAGER)
(787) 891-4851
Entity
Organization
Contact information
Practice address
EDIFICIO HERNANDEZ, STE # 1, AGUADILLA, PR 00603
(787) 891-4851
(787) 891-4851
Mailing address
PO BOX 5080, STE. # 167, AGUADILLA, PR 00605-5080
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
12658
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1139
HEALTH DEPARTMENT PIN NUM
PR
Enumeration date
04/26/2007
Last updated
08/22/2020
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