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General NPI Number Information
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NPI Number | 1528222676
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Entity Type | Organization
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Legal Business Name | DAJAOS MEDICAL CENTER CSP
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 167 ROAD KM 11 0 BO DAJAOS
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City | BAYAMON
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State | PR
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Zip | 00956-9711
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Country | US
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Telephone | 787-730-3446
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Fax |
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Provider Business Mailing Address
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Address Line | RR 14 BOX 5334
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City | BAYAMON
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State | PR
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Zip | 00956-9711
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Country | US
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Telephone | 787-730-3446
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAFAEL VAZQUEZ PEREZ
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Credential | MD
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Telephone | 787-730-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 894CP
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License Number State | PR
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