MEDICARE: VIR ARZOLA P.S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician	14049	PR

General Provider Information

NPI Number	:	1730325101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIR ARZOLA P.S.C.

Provider Business Mailing Address
First Line	:	1948 CALLE JOSE FIDALGO DIAZ
Second Line	:	ALTURAS DE CALDAS, APT 141
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5326
Country	:	US
Telephone Number	:	787-415-9192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1948 CALLE JOSE FIDALGO DIAZ
Second Line	:	ALTURAS DE CALDAS, APT 141
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5326
Country	:	US
Telephone Number	:	787-415-9192
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JORGE ARZOLA
Credential	:	MD
Telephone Number	:	787-415-9192

Provider Enumeration Date	:	01/06/2009
Last Update Date	:	01/06/2009

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