Healthcare Provider Details

I. General information

NPI: 1659503795
Provider Name (Legal Business Name): NEW VISION MEDICAL DIAGNOSTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE BARBOSA #36 ESQUINA MANUEL F ROSSY
BAYAMON PR
00960
US

IV. Provider business mailing address

PO BOX 6350
BAYAMON PR
00960-5350
US

V. Phone/Fax

Practice location:
  • Phone: 787-778-5353
  • Fax: 787-778-5302
Mailing address:
  • Phone: 787-778-5353
  • Fax: 787-778-5302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number43
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE J VARGAS RODRIGUEZ
Title or Position: PRESIDENT
Credential:
Phone: 787-778-5353