| Organization Name: | SAN JUAN VAMC |
| NPI Number: | 1275801029 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LISA DUNCAN (EBILLING MANAGER) |
| Mailing Address: | Building Lot #3 Pr-3 Km 54.9, Pueblo Ward Ceiba |
| State: | PR US |
| Postal Code: | 007359998 |
| Phone Number: | 7876415870 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2011 |
| NPI Last Update Date: | 11/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QV0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | VA |
| Taxonomy Definition: | |