Organization
DLA IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSUE VAZQUEZ MD (PRESIDENT)
(987) 975-9521
Entity
Organization
Contact information
Practice address
URBANIZACION TINTILLO HILLS, #522 CALLE TINTILLO, GUAYNABO, PR 00966
(787) 975-9521
Mailing address
PO BOX 1097, LAS PIEDRAS, PR 00771
(787) 975-9521
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037618801
—
PR
Enumeration date
06/01/2016
Last updated
01/25/2024
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