Organization
DAJAOS MEDICAL CENTER CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL VAZQUEZ M.D. (PRESIDENT)
(787) 730-3446
Entity
Organization
Contact information
Practice address
167 ROAD KM 11, BAYAMON, PR 00956-9711
(787) 730-3446
Mailing address
RR 5 BOX 5334, BAYAMON, PR 00956-9711
(787) 730-3446
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
9999
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065480
CRUZ AZUL
PR
01
—
201279
PREFERED
PR
01
—
2081
SMERICAN HEALTH
PR
01
—
500140E
CRUZ AZUL
PR
01
—
6320088
HUMANA
PR
01
—
82253
SSS
PR
01
—
N198
FIRS T PLUS
PR
Enumeration date
05/23/2007
Last updated
08/22/2020
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