Provider Demographics
NPI:1194311712
Name:DOCTORAS ZARAGOZA- VACUNAS Y CERTIFICADOS DE SALUD LLC
Entity type:Organization
Organization Name:DOCTORAS ZARAGOZA- VACUNAS Y CERTIFICADOS DE SALUD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CELLYMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARAGOZA RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-841-5549
Mailing Address - Street 1:PMB 157 PO BOX 780
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715
Mailing Address - Country:US
Mailing Address - Phone:787-841-5549
Mailing Address - Fax:787-840-3030
Practice Address - Street 1:909 AVE TITO CASTRO SUITE 717
Practice Address - Street 2:TORRE MEDICA SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-0071
Practice Address - Country:US
Practice Address - Phone:787-841-5549
Practice Address - Fax:787-840-3030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTORAZ ZARAGOZA- VACUNAS Y CERTIFICADOS DE SALUD LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-17
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Multi-Specialty