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General NPI Number Information
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NPI Number | 1609060581
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Entity Type | Organization
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Legal Business Name | DIAMAGE INSTITUTE
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | CALLE BALDORIOTY DE CASTRO 1B
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-447-7196
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Fax |
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Provider Business Mailing Address
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Address Line | D5 CALLE A EL ROSARIO
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-447-7196
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Fax |
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Authorized Official
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Title or Position | VASCULAR SONOGRAPHER
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Name | MS. JANICE MENDEZ
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Credential | REGISTRY #6869
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Telephone | 787-447-7196
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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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