Organization
BV INFANT NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM R DIAZ JR. (PRESIDENT)
(939) 640-2052
Entity
Organization
Contact information
Practice address
LOCAL #5 CALLE RAMON DE JESUS SIERRA, LARES, PR 00669
(939) 640-2052
Mailing address
PO BOX 187, CATANO, PR 00963-0187
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
343800000X
Secured Medical Transport (VAN)
—
—
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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