MRS. Wanda Ivette Vidal, M.D.

NPI #1790995363 in Fajardo, Puerto Rico

Provider Information

NPI Number: 1790995363
Entity Type: Individual
Name: MRS. Wanda Ivette Vidal, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: General Practice
Credential: M.D.
Enumeration Date: May 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: AVE. GENERAL VALERO #404
City: Fajardo
State: Puerto Rico
ZIP Code: 00738
Phone: (787) 655-0505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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