Isla Blanca Llc | |
210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 | |
(201) 450-5043 | |
Not Available |
Full Name | Isla Blanca Llc |
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Speciality | General Practice |
Location | 210 Calle Jose Oliver Apt 1209, San Juan, Puerto Rico |
Authorized Official Name and Position | Victor H Cordero (PRESIDENT) |
Authorized Official Contact | 2014505043 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Isla Blanca Llc 210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 Ph: (201) 450-5043 | Isla Blanca Llc 210 Calle Jose Oliver Apt 1209 San Juan PR 00918-2985 Ph: (201) 450-5043 |
NPI Number | 1518736230 |
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Provider Enumeration Date | 12/21/2023 |
Last Update Date | 12/21/2023 |
Medicare PECOS PAC ID | 8325486962 |
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Medicare Enrollment ID | O20240402002729 |
Identifier | Type | State | Issuer |
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1518736230 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Victor H Cordero |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1578916102 PECOS PAC ID: 9537413737 Enrollment ID: I20181106002083 |
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