Provider Demographics
NPI:1891043337
Name:NEW VISION MEDICAL DIAGNOSTIC INC
Entity Type:Organization
Organization Name:NEW VISION MEDICAL DIAGNOSTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:J
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-778-5353
Mailing Address - Street 1:PO BOX 6350
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-5350
Mailing Address - Country:US
Mailing Address - Phone:787-778-5353
Mailing Address - Fax:787-778-5302
Practice Address - Street 1:BAYAMON MEDICAL MALL # J-23
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-778-5353
Practice Address - Fax:787-778-5302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1659503795
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care