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General NPI Number Information
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NPI Number | 1528249265
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Entity Type | Organization
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Legal Business Name | CLINICA DE CANCER Y ENFERMEDADES DE LA SANGRE, CSP
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | CARR 460 KM 0.2 BO CAIMITAL BAJO
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City | AGUADILLA
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State | PR
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Zip | 00603-4055
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Country | US
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Telephone | 787-882-3975
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Fax | 787-997-0123
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Provider Business Mailing Address
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Address Line | PO BOX 5191
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City | AGUADILLA
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State | PR
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Zip | 00605
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Country | US
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Telephone | 787-882-3975
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTOR J VAZQUEZ-RODRIGUEZ
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Credential | MD
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Telephone | 787-882-3975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number |
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License Number State |
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