# VASCULAR DIAGNOSTIC GROUP CORP PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114319183
- **Authorized official:** MR. FERNANDO JIMENEZ (ADMINISTRATOR)
- **Authorized official phone:** (787) 210-8795

## Contact information

- **Practice address:** RES VILLA DEL REY \# 3, SABOYA A4, CAGUAS, PR 00725-7113
- **Practice address phone:** (787) 210-8795
- **Practice address fax:** (787) 258-5487
- **Mailing address:** RES VILLA DEL REY \# 3, SABOYA A4, CAGUAS, PR 00725-7113
- **Mailing address phone:** (787) 210-8795
- **Mailing address fax:** (787) 258-5487

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | PR | Yes |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 02/26/2015