Doctor Name: | DR. JADEYRA RIVAS VARGAS |
NPI Number: | 1154633147 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 18132 |
Business Practice Address: | 150 Ave Font Martelo Humacao, PR - 007913346 |
Business Phone Number: | 7878617777 |
Business Fax Number: | 7872855608 |
Mailing Address: | Po Box 10287, HUMACAO |
State: | PR |
Postal Code: | 007921300 |
Phone Number: | 7876133999 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2010 |
NPI Last Update Date: | 06/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 18132 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |