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Organization

NUCLEAR RADIOLOGY, CSP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RAFAEL A VAQUER MD (PRESIDENT)
(787) 474-8878
Entity
Organization

Contact information

Practice address
HOSP AUXILIO MUTUO, 715 AVE PONCE DE LEON, PDA 37 1/2, EDIF NINO DIVINO JESUS, CENTRO IMAGENES DE LA MUJER, HATO REY, PR 00917
(787) 474-8878
(787) 771-7445
Mailing address
100 GRAN PASEOS BULEVAR, SUITE 112-137, SAN JUAN, PR 00926-5905
(787) 474-8878
(787) 771-7445

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EC962A
PTAN
PR
Enumeration date
05/10/2007
Last updated
07/17/2013
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