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General NPI Number Information
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NPI Number | 1194814327
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Entity Type | Organization
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Legal Business Name | ADVANCED IMAGING AND VASCULAR CENTER
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR. 172 3B12 3RA. SECCION VILLA DEL REY
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City | CAGUAS
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State | PR
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Zip | 00726-5254
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Country | US
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Telephone | 787-744-0400
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Fax | 787-286-0539
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Provider Business Mailing Address
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Address Line | PO BOX 5254
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City | CAGUAS
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State | PR
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Zip | 00726-5254
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Country | US
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Telephone | 787-744-0400
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Fax | 787-286-0539
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ANGELA M TORREGROSA VICENTE
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Credential |
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Telephone | 787-744-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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