Healthcare Provider Details

I. General information

NPI: 1588707012
Provider Name (Legal Business Name): VASCULAR INTERPRETATION GROUP PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405A CALLE MONTILLA URB PARQUE CENTRAL
SAN JUAN PR
00918-2607
US

IV. Provider business mailing address

405A CALLE MONTILLA URB PARQUE CENTRAL
SAN JUAN PR
00918-2607
US

V. Phone/Fax

Practice location:
  • Phone: 787-250-7157
  • Fax:
Mailing address:
  • Phone: 787-250-7157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JOSE CARLOS COLON
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-250-7157