Individual
MISS JOANN ALEXANDRA VIDAL RODRIGUEZ I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CARRETERA 2 KM 173.4, SAN GERMAN, PR 00683-0285
(787) 892-1860
Mailing address
PO BOX 1606, HORMIGUEROS, PR 00660
(787) 384-5118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33910-R
PR
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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