Provider Demographics
NPI:1508827551
Name:INSTITUTO CIRUGIA PLASTICA DEL OESTE INC
Entity Type:Organization
Organization Name:INSTITUTO CIRUGIA PLASTICA DEL OESTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-833-3248
Mailing Address - Street 1:165 MENDEZ VIGO E
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-5049
Mailing Address - Country:US
Mailing Address - Phone:787-833-3248
Mailing Address - Fax:787-831-4400
Practice Address - Street 1:165 MENDEZ VIGO E
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5049
Practice Address - Country:US
Practice Address - Phone:787-833-3248
Practice Address - Fax:787-831-4400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0010232Medicare ID - Type Unspecified