Provider Demographics
NPI:1609060581
Name:DIAMAGE INSTITUTE
Entity Type:Organization
Organization Name:DIAMAGE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VASCULAR SONOGRAPHER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTRY #6869
Authorized Official - Phone:787-447-7196
Mailing Address - Street 1:D5 CALLE A EL ROSARIO
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-447-7196
Mailing Address - Fax:
Practice Address - Street 1:CALLE BALDORIOTY DE CASTRO 1B
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-447-7196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology