Provider Demographics
NPI:1194814327
Name:ADVANCED IMAGING AND VASCULAR CENTER
Entity Type:Organization
Organization Name:ADVANCED IMAGING AND VASCULAR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORREGROSA VICENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-744-0400
Mailing Address - Street 1:PO BOX 5254
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5254
Mailing Address - Country:US
Mailing Address - Phone:787-744-0400
Mailing Address - Fax:787-286-0539
Practice Address - Street 1:CARR. 172 3B12 3RA. SECCION VILLA DEL REY
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726-5254
Practice Address - Country:US
Practice Address - Phone:787-744-0400
Practice Address - Fax:787-286-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0080228Medicare ID - Type Unspecified