# CENTRO DE CANCER DE LA MONTANA CSP

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

## Provider details

- **NPI number:** 1225020662
- **Authorized official:** WILLIAM SIERRA (DIRECTOR RH)
- **Authorized official phone:** (787) 740-3230

## Contact information

- **Practice address:** JOSE C. VAZQUEZ \#1 DR. TROCHE, KM 4 INTERIOR, CARR. 726, AIBONITO, PR 00705
- **Practice address phone:** (787) 735-1888
- **Practice address fax:** (787) 735-2080
- **Mailing address:** 1353 AVE LUIS VIGOREAUX, PMB 472, GUAYNABO, PR 00966-2715
- **Mailing address phone:** (787) 740-3230
- **Mailing address fax:** (787) 993-6010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | Yes |
| 207RH0003X | Hematology & Oncology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2005
- **Last updated:** 06/20/2014