Organization Name: | MV HEALTHCARE CSP |
NPI Number: | 1013325380 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIGUEL J MORALES VALES (PRESIDENT) |
Mailing Address: | 98 Calle Garrido Morales E Fajardo |
State: | PR US |
Postal Code: | 007384678 |
Phone Number: | 7878605140 |
Fax Number: | 7878605140 |
NPI Enumeration Date: | 07/30/2014 |
NPI Last Update Date: | 08/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 9455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |