Provider Demographics
NPI:1245566447
Name:CDT DE VEGA BAJA
Entity Type:Organization
Organization Name:CDT DE VEGA BAJA
Other - Org Name:MEDICAL EMERGENCY GROUP JRJ, CSP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-745-0708
Mailing Address - Street 1:PO BOX 1388
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00726
Mailing Address - Country:UM
Mailing Address - Phone:787-745-0708
Mailing Address - Fax:787-744-8065
Practice Address - Street 1:URB VILLA PINARES
Practice Address - Street 2:CALLE PASEO VILLA PINARES 81
Practice Address - City:VEGA BAJA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00693
Practice Address - Country:UM
Practice Address - Phone:787-858-2416
Practice Address - Fax:787-744-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care