Provider Demographics
NPI:1730806100
Name:ABC VACUNA T INC
Entity type:Organization
Organization Name:ABC VACUNA T INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:DE LOURDES
Authorized Official - Last Name:BRAVO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:787-932-0800
Mailing Address - Street 1:PO BOX 9525
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9525
Mailing Address - Country:US
Mailing Address - Phone:787-501-8042
Mailing Address - Fax:
Practice Address - Street 1:A4 AVE DEGETAU
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-4340
Practice Address - Country:US
Practice Address - Phone:787-501-8042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-25
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service