Organization
VACCINE PROVIDER LLC
Active
Organization
VACCINE PROVIDER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN MORALES (OWNER)
(787) 367-2457
Entity
Organization
Contact information
Practice address
LIBERTY PLAZA CAYEY LOCAL #9, CAYEY, PR 00736
(787) 367-2457
Mailing address
URB GOLDEN GATE II, P21 CALLE G, CAGUAS, PR 00725
(787) 367-2457
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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