# DAJAOS MEDICAL CENTER CSP

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

## Provider details

- **NPI number:** 1528222676
- **Authorized official:** RAFAEL VAZQUEZ PEREZ MD (PRESIDENT)
- **Authorized official phone:** (787) 730-3446

## Contact information

- **Practice address:** 167 ROAD KM 11 0 BO DAJAOS, BAYAMON, PR 00956-9711
- **Practice address phone:** (787) 730-3446
- **Mailing address:** RR 14 BOX 5334, BAYAMON, PR 00956-9711
- **Mailing address phone:** (787) 730-3446

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 894CP | PR | Yes |

## Other

- **Enumeration date:** 07/17/2008
- **Last updated:** 07/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 06548O | CRUZ AZUL | PR |
| 01 | — | 500140 | MMM | PR |
| 01 | — | 6320088 | HUMANA | PR |
| 01 | — | 82154 | SSS | PR |