# CLINICA CIRUGIA AMBULATORIA DR. LUIS A. VAZQUEZ, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINICA DE CIRUGIA AMBULATORIA DE PR
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801967815
- **Authorized official:** MR. JESUS NIEVES ROSAIO MSHA MBA (ADMINISTRATOR)
- **Authorized official phone:** (787) 833-4400

## Contact information

- **Practice address:** CALLE PERAL ESQ DE DIEGO, EDIFICIO LA PALMA PISO 6, MAYAGUEZ, PR 00680
- **Practice address phone:** (787) 833-4400
- **Practice address fax:** (787) 265-6621
- **Mailing address:** PO BOX 3748, MAYAGUEZ, PR 00681-3748
- **Mailing address phone:** (787) 833-4400
- **Mailing address fax:** (787) 265-6621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 87 | PR | Yes |
| 291U00000X | Clinical Medical Laboratory | 745 | PR | — |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 06/22/2020