# BIOMOLECULAR PERSONAL CANCER CENTER LLC

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

## Provider details

- **NPI number:** 1861100703
- **Authorized official:** VIDAL ROSARIO LEON MD (PRESIDENT)
- **Authorized official phone:** (787) 735-4404

## Contact information

- **Practice address:** 108 CALLE JOSE C VAZQUEZ, AIBONITO, PR 00705-3309
- **Practice address phone:** (787) 735-4404
- **Mailing address:** PO BOX 372350, CAYEY, PR 00737-2350
- **Mailing address phone:** (787) 735-4404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZC0006X | Clinical Pathology Physician | — | NULL | — |
| 207ZC0006X | Clinical Pathology Physician | — | — | — |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 11/09/2022
- **Last updated:** 11/09/2022