Provider Demographics
NPI:1477588333
Name:INSTITUTO DE DIAGNOSTICO VASCULAR INC
Entity Type:Organization
Organization Name:INSTITUTO DE DIAGNOSTICO VASCULAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:FELIX
Authorized Official - Last Name:GARCIA RINALDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-831-1607
Mailing Address - Street 1:PO BOX 6684
Mailing Address - Street 2:MARINA STATION
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6684
Mailing Address - Country:US
Mailing Address - Phone:787-833-5557
Mailing Address - Fax:787-265-3711
Practice Address - Street 1:CARR. #2 AVE. HOSTOS # 410
Practice Address - Street 2:CENTRO MEDICO 1ER PISO
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00681-6353
Practice Address - Country:US
Practice Address - Phone:787-833-5557
Practice Address - Fax:787-265-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR55102085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082788Medicare PIN