Healthcare Provider Details

I. General information

NPI: 1063243996
Provider Name (Legal Business Name): VASCULAR INSTITUTE OF PUERTO RICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CENTRO MEDICO MENONITA DE CAYEY OFICINA 205
CAYEY PR
00736-4107
US

IV. Provider business mailing address

35 CALLE JUAN C BORBON STE 67-148
GUAYNABO PR
00969-5374
US

V. Phone/Fax

Practice location:
  • Phone: 787-639-8835
  • Fax: 787-535-1050
Mailing address:
  • Phone: 787-639-8835
  • Fax: 787-535-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. GABRIEL A PEREIRA TORRELLAS
Title or Position: PRESIDENTE
Credential: MD
Phone: 787-639-8835